Healthcare Provider Details

I. General information

NPI: 1043402928
Provider Name (Legal Business Name): DAVID SCOTT FARLEY NURSE PRACTITIONER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2007
Last Update Date: 10/06/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1650 COCHRANE CIR REYNOLDS ARMY COMMUNITY HOSPITAL (ATTN: MS PRESCOTT)
FT CARSON CO
80913-4613
US

IV. Provider business mailing address

1650 COCHRANE CIR REYNOLDS ARMY COMMUNITY HOSPITAL (ATTN: MS PRESCOTT)
FT CARSON CO
80913-4613
US

V. Phone/Fax

Practice location:
  • Phone: 719-526-0502
  • Fax: 719-526-7132
Mailing address:
  • Phone: 719-526-0502
  • Fax: 719-526-7132

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number467826
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: