Provider Demographics
NPI:1558388983
Name:FARRAN, NICOLE ANNE NEFFGEN (NURSE PRACTITIONER)
Entity type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:ANNE NEFFGEN
Last Name:FARRAN
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:MISS
Other - First Name:NICOLE
Other - Middle Name:ANNE
Other - Last Name:NEFFGEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NURSE PRACTITIONER
Mailing Address - Street 1:25 DANIELSEN WAY
Mailing Address - Street 2:
Mailing Address - City:GREER
Mailing Address - State:SC
Mailing Address - Zip Code:29651-7364
Mailing Address - Country:US
Mailing Address - Phone:864-320-9191
Mailing Address - Fax:
Practice Address - Street 1:3900 S HIGHWAY 14 STE 2A
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615-7110
Practice Address - Country:US
Practice Address - Phone:864-320-9191
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-15
Last Update Date:2025-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCSC18757207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4247097OtherBCBS OF TENNESSEE
TNAPN0000011599OtherNURSE PRACTITIONER