| Doctor Name: | MS. SUSAN ANN FARRELL |
| NPI Number: | 1164502043 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | ARNP |
| License Number: | 1010017349 |
| Business Practice Address: | 331 Upper Plain Bradford, VT - 05033 |
| Business Phone Number: | 8022224722 |
| Business Fax Number: | 8022224709 |
| Mailing Address: | Po Box 206, THETFORD CTR |
| State: | VT |
| Postal Code: | 05075 |
| Phone Number: | 8027852822 |
| Fax Number: | |
| NPI Enumeration Date: | 10/16/2006 |
| NPI Last Update Date: | 12/01/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0200X |
| License Number: | 1010017349 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VT |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |