Willis-Farmer, Kathleen
Willis-Farmer, Kathleen is an sole proprietor health care provider with primary practice located at 10590 Enduring Freedom Drive , Fort Drum NY 13602. She recently has only one registered license in Dental Providers / Dental Hygienist, which is considered as her primary health care specialty. Willis-Farmer, Kathleen can be contacted via phone (315) 772-6234.Contact Information
Primary practice address
10590 Enduring Freedom Drive
Fort Drum NY 13602
Phone: (315) 772-6234
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dental Hygienist | 124Q00000X | ||
| Dental Providers / Dental Hygienist | 124Q00000X | 19916 | California |
Profile Details
| NPI number | 1578054367 |
|---|---|
| LBN Legal business name | Willis-Farmer, Kathleen |
| Credentials | Registered Dental Hygienist (RDH) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 29th, 2018 |
| Last updated | Jun 26th, 2018 - about 7 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1578054367 | NPPES |
| California | Other | 19916 | MILITARY BASE |
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