Provider Demographics
NPI:1154573921
Name:FARNUM, CHRISTINE
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:FARNUM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 BRENNER DR
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:NH
Mailing Address - Zip Code:03858-3801
Mailing Address - Country:US
Mailing Address - Phone:404-345-0662
Mailing Address - Fax:
Practice Address - Street 1:18 BRENNER DR
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:NH
Practice Address - Zip Code:03858-3801
Practice Address - Country:US
Practice Address - Phone:404-345-0662
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-10
Last Update Date:2008-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL10663314000000X
GA000754314000000X
MA1211314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility