Provider Demographics
NPI:1184282055
Name:FARRY, VERONICA (LVN)
Entity type:Individual
Prefix:
First Name:VERONICA
Middle Name:
Last Name:FARRY
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10535 MONTWOOD DR APT 141
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79935-2721
Mailing Address - Country:US
Mailing Address - Phone:915-321-2434
Mailing Address - Fax:
Practice Address - Street 1:10535 MONTWOOD DR APT 141
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79935-2721
Practice Address - Country:US
Practice Address - Phone:915-321-2434
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-05
Last Update Date:2019-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX343053164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse