Provider Demographics
NPI:1811861768
Name:FARLEY, PATRICIA WALLACE (RN)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:WALLACE
Last Name:FARLEY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3475 LURMAN DR
Mailing Address - Street 2:
Mailing Address - City:MACUNGIE
Mailing Address - State:PA
Mailing Address - Zip Code:18062-2142
Mailing Address - Country:US
Mailing Address - Phone:585-309-4745
Mailing Address - Fax:
Practice Address - Street 1:3475 LURMAN DR
Practice Address - Street 2:
Practice Address - City:MACUNGIE
Practice Address - State:PA
Practice Address - Zip Code:18062-2142
Practice Address - Country:US
Practice Address - Phone:585-309-4745
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-02
Last Update Date:2025-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA636461163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse