| Doctor Name: | KARYN HARVEY FAREVAAG |
| NPI Number: | 1215364062 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | ANP |
| License Number: | RN265605 |
| Business Practice Address: | 11 Quarry Hill Road Lee, MA - 01238 |
| Business Phone Number: | 4132430536 |
| Business Fax Number: | 4132436332 |
| Mailing Address: | 444 Stockbridge Road, GREAT BARRINGTON |
| State: | MA |
| Postal Code: | 01230 |
| Phone Number: | 4135289311 |
| Fax Number: | 4135282863 |
| NPI Enumeration Date: | 10/10/2013 |
| NPI Last Update Date: | 10/10/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2200X |
| License Number: | RN265605 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Adult Health |
| Taxonomy Definition: | |