Provider Demographics
NPI:1588364707
Name:FARR, EMILY JO (MLS)
Entity type:Individual
Prefix:MS
First Name:EMILY
Middle Name:JO
Last Name:FARR
Suffix:
Gender:F
Credentials:MLS
Other - Prefix:MRS
Other - First Name:EMILY
Other - Middle Name:JO
Other - Last Name:AMEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1151 SE VILLAGE VIEW LN
Mailing Address - Street 2:
Mailing Address - City:ANKENY
Mailing Address - State:IA
Mailing Address - Zip Code:50021-4027
Mailing Address - Country:US
Mailing Address - Phone:515-570-9171
Mailing Address - Fax:
Practice Address - Street 1:3600 30TH ST
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50310-5753
Practice Address - Country:US
Practice Address - Phone:515-699-5999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-07
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA277104246QM0706X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246QM0706XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, PathologyMedical Technologist