Provider Demographics
NPI:1316711351
Name:FARRAR, CAITLIN L (RN)
Entity type:Individual
Prefix:
First Name:CAITLIN
Middle Name:L
Last Name:FARRAR
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:CAITLIN
Other - Middle Name:L
Other - Last Name:SHEA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1 PINECREST DR
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03110-5534
Mailing Address - Country:US
Mailing Address - Phone:603-921-9085
Mailing Address - Fax:
Practice Address - Street 1:25 RIDGEWOOD RD
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:NH
Practice Address - Zip Code:03110-6510
Practice Address - Country:US
Practice Address - Phone:603-623-8805
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-09
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2346286163WE0003X
NH073642-21163WR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0400XNursing Service ProvidersRegistered NurseRehabilitation
No163WE0003XNursing Service ProvidersRegistered NurseEmergency