Provider Demographics
NPI:1982417051
Name:FARHAN, SAM
Entity type:Individual
Prefix:
First Name:SAM
Middle Name:
Last Name:FARHAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3316 NEERPARK DR
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506-4525
Mailing Address - Country:US
Mailing Address - Phone:402-480-4146
Mailing Address - Fax:
Practice Address - Street 1:1501 HILLTOP RD APT 111
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68521-7402
Practice Address - Country:US
Practice Address - Phone:402-975-2469
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-30
Last Update Date:2025-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker