Provider Demographics
NPI:1427331842
Name:FARLEY, JENNIFER GAYLE (APRN, CPNP-AC)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:GAYLE
Last Name:FARLEY
Suffix:
Gender:F
Credentials:APRN, CPNP-AC
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Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:1301 BARBARA JORDAN BLVD STE 200G
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78723-3078
Mailing Address - Country:US
Mailing Address - Phone:512-324-0907
Mailing Address - Fax:512-324-0643
Practice Address - Street 1:1301 BARBARA JORDAN BLVD STE 307
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78723-3080
Practice Address - Country:US
Practice Address - Phone:512-324-9999
Practice Address - Fax:512-324-0643
Is Sole Proprietor?:No
Enumeration Date:2011-09-21
Last Update Date:2020-02-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX720783363LA2100X, 363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care