Provider Demographics
NPI:1588383574
Name:FARMER, AMY DIXON (NP)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:DIXON
Last Name:FARMER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3601 OLD LAURENS RD
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:SC
Mailing Address - Zip Code:29649-9777
Mailing Address - Country:US
Mailing Address - Phone:864-941-0185
Mailing Address - Fax:
Practice Address - Street 1:103 LINER DR
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:SC
Practice Address - Zip Code:29646-2311
Practice Address - Country:US
Practice Address - Phone:864-227-3636
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-24
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC26923363L00000X
GARN217787363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner