Provider Demographics
NPI:1194559492
Name:KELLY M. FARROW, FAMILY HEALTH NURSE PRACTITIONER PC
Entity type:Organization
Organization Name:KELLY M. FARROW, FAMILY HEALTH NURSE PRACTITIONER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:M
Authorized Official - Last Name:FARROW
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-BC
Authorized Official - Phone:585-386-3860
Mailing Address - Street 1:1900 EMPIRE BLVD
Mailing Address - Street 2:UPS SUITE 195
Mailing Address - City:WEBSTER
Mailing Address - State:NY
Mailing Address - Zip Code:14580
Mailing Address - Country:US
Mailing Address - Phone:585-386-3860
Mailing Address - Fax:585-326-3025
Practice Address - Street 1:500 HELENDALE RD STE 150
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14609-3167
Practice Address - Country:US
Practice Address - Phone:585-386-3860
Practice Address - Fax:585-326-3025
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-28
Last Update Date:2025-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care