Provider Demographics
NPI:1699952655
Name:FARLEY, MARY BEATRICE (FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:MARY
Middle Name:BEATRICE
Last Name:FARLEY
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:501 MORRIS ST
Mailing Address - Street 2:SHORT STAY SURGERY CAMC
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25301-1326
Mailing Address - Country:US
Mailing Address - Phone:304-388-6249
Mailing Address - Fax:304-388-6344
Practice Address - Street 1:501 MORRIS ST
Practice Address - Street 2:SHORT STAY SURGERY CAMC
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25301-1326
Practice Address - Country:US
Practice Address - Phone:304-388-6249
Practice Address - Fax:304-388-6344
Is Sole Proprietor?:No
Enumeration Date:2008-01-22
Last Update Date:2008-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV055735363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily