Provider Demographics
NPI:1720834872
Name:FARMER, ANDREA HOLLAND
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:HOLLAND
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 1:2331 COUNCIL LN
Mailing Address - Street 2:
Mailing Address - City:BUFORD
Mailing Address - State:GA
Mailing Address - Zip Code:30519-8008
Mailing Address - Country:US
Mailing Address - Phone:770-500-5602
Mailing Address - Fax:
Practice Address - Street 1:231 WEST HANCOCK ST
Practice Address - Street 2:CAMPUS BOX 063
Practice Address - City:MILLEDGEVILLE
Practice Address - State:GA
Practice Address - Zip Code:31061
Practice Address - Country:US
Practice Address - Phone:478-445-1076
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-29
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program