Individual provider · Type 1 NPI

Farah Octavien, AGNP

Gerontology Clinical Nurse Specialist · Ellenwood, GA

NPI number 1629629613 Active

Practice location

2873 Village Park Dr E
Ellenwood, GA 30294-5712

Call (678) 571-0918 Map

Specialties and licenses

TaxonomyCodeLicense
Gerontology Clinical Nurse Specialist Primary 364SG0600XAG03190021 (GA)

Gerontology Clinical Nurse Specialist: Definition to come...

About NPI 1629629613

Farah Octavien, AGNP's National Provider Identifier is 1629629613, issued on Sep 22, 2019. The primary taxonomy on file is Gerontology Clinical Nurse Specialist (364SG0600X), and the practice location is in Ellenwood, GA. The record was last updated on Sep 22, 2019.