Provider Demographics
NPI:1912704388
Name:FARLEY, LUDDIE SHAWN
Entity type:Individual
Prefix:
First Name:LUDDIE
Middle Name:SHAWN
Last Name:FARLEY
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2
Mailing Address - Street 2:
Mailing Address - City:LAYLAND
Mailing Address - State:WV
Mailing Address - Zip Code:25864-0002
Mailing Address - Country:US
Mailing Address - Phone:681-222-9115
Mailing Address - Fax:
Practice Address - Street 1:259 LAYLAND HEIGHTS RD BOX 2
Practice Address - Street 2:
Practice Address - City:LAYLAND
Practice Address - State:WV
Practice Address - Zip Code:25864-2586
Practice Address - Country:US
Practice Address - Phone:681-222-8837
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-25
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion
No251E00000XAgenciesHome Health