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General NPI Number Information
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NPI Number | 1700699469
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Entity Type | Individual
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Provider Name | TINA CHRISTINE FARLEY
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Gender | Female
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Dates
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Enumeration Date | 01/28/2025
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Last Update Date | 01/28/2025
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Provider Practice Location Address
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Address Line | 1514 BURLINGTON BLVD
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City | NORTH PLATTE
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State | NE
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Zip | 69101-5733
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Country | US
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Telephone | 308-530-9623
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Fax |
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Provider Business Mailing Address
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Address Line | 1214 CEDARBERRY RD
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City | NORTH PLATTE
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State | NE
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Zip | 69101-5948
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Country | US
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Telephone | 308-530-8983
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 372500000X
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Taxonomy Name | Chore Provider
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License Number |
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License Number State | NE
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