Healthcare Provider Details

I. General information

NPI: 1790087112
Provider Name (Legal Business Name): ANDI CARROLL FARLEY MSN,WHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/18/2010
Last Update Date: 06/28/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 6TH AVE S
BIRMINGHAM AL
35233-1602
US

IV. Provider business mailing address

PO BOX 55310
BIRMINGHAM AL
35255-5310
US

V. Phone/Fax

Practice location:
  • Phone: 205-934-2170
  • Fax:
Mailing address:
  • Phone: 205-731-9701
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number1100927
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number1-100927
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: