Provider Demographics
NPI:1235503475
Name:FARLEY, SEAN J (RN, BSN, CCRN)
Entity type:Individual
Prefix:
First Name:SEAN
Middle Name:J
Last Name:FARLEY
Suffix:
Gender:M
Credentials:RN, BSN, CCRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43 WHITING HILL
Mailing Address - Street 2:SUITE 300
Mailing Address - City:BREWER
Mailing Address - State:ME
Mailing Address - Zip Code:04412
Mailing Address - Country:US
Mailing Address - Phone:207-973-5293
Mailing Address - Fax:
Practice Address - Street 1:1 NORTHEAST DR
Practice Address - Street 2:
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-4332
Practice Address - Country:US
Practice Address - Phone:207-275-3800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-28
Last Update Date:2021-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY545463163WC0200X
NJ26NR11263800163WC0200X
MECNP161216363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine