Provider Demographics
NPI:1528510088
Name:FARMER, KAYRENE
Entity type:Individual
Prefix:
First Name:KAYRENE
Middle Name:
Last Name:FARMER
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 1:8002 KEW GARDENS RD
Mailing Address - Street 2:#303
Mailing Address - City:KEW GARDENS
Mailing Address - State:NY
Mailing Address - Zip Code:11415-3600
Mailing Address - Country:US
Mailing Address - Phone:718-459-5592
Mailing Address - Fax:
Practice Address - Street 1:8002 KEW GARDENS RD
Practice Address - Street 2:#303
Practice Address - City:KEW GARDENS
Practice Address - State:NY
Practice Address - Zip Code:11415-3600
Practice Address - Country:US
Practice Address - Phone:718-459-5592
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-01
Last Update Date:2016-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY325844164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse