Healthcare Provider Details

I. General information

NPI: 1609176833
Provider Name (Legal Business Name): PATRICIA FARLEY MOORE M.A.E.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MISS PATRICIA LYNNE FARLEY

II. Dates (important events)

Enumeration Date: 10/21/2010
Last Update Date: 10/21/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

343 WALLER AVE SUITE 201
LEXINGTON KY
40504-2912
US

IV. Provider business mailing address

343 WALLER AVE SUITE 201
LEXINGTON KY
40504-2912
US

V. Phone/Fax

Practice location:
  • Phone: 859-271-9448
  • Fax: 272-689-3291
Mailing address:
  • Phone: 859-271-9448
  • Fax: 272-689-3291

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: