| Doctor Name: | AMANDA M FARRELL |
| NPI Number: | 1023433877 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | APNP |
| License Number: | 5678 |
| Business Practice Address: | 9900 Bren Rd E Minnetonka, MN - 553439664 |
| Business Phone Number: | 8003285979 |
| Business Fax Number: | 8552526933 |
| Mailing Address: | 1710 E Menlo Blvd, SHOREWOOD |
| State: | WI |
| Postal Code: | 532112250 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 03/03/2014 |
| NPI Last Update Date: | 11/14/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 5678 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WI |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |