1407988140 NPI number — CYNTHIA L. FARLEY CNM

Table of content: (NPI 1154023935)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1407988140 NPI number — CYNTHIA L. FARLEY CNM

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FARLEY
Provider First Name:
CYNTHIA
Provider Middle Name:
L.
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
CNM
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1407988140
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/03/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
313 N WINTER ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
YELLOW SPRINGS
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45387-2048
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
937-767-1990
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
234 GOODMAN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CINCINNATI
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45219-2364
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
513-584-4800
Provider Business Practice Location Address Fax Number:
513-584-4081
Provider Enumeration Date:
03/09/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 367A00000X , with the licence number:  NM00315 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 7100026040 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0568354 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2026 www.npivalidator.com