Provider Demographics
NPI:1407988140
Name:FARLEY, CYNTHIA L (CNM)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:L
Last Name:FARLEY
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:313 N WINTER ST
Mailing Address - Street 2:
Mailing Address - City:YELLOW SPRINGS
Mailing Address - State:OH
Mailing Address - Zip Code:45387-2048
Mailing Address - Country:US
Mailing Address - Phone:937-767-1990
Mailing Address - Fax:
Practice Address - Street 1:234 GOODMAN ST
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45219-2364
Practice Address - Country:US
Practice Address - Phone:513-584-4800
Practice Address - Fax:513-584-4081
Is Sole Proprietor?:No
Enumeration Date:2007-03-09
Last Update Date:2015-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNM00315367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100026040Medicaid
OH0568354Medicaid
KY7100026040Medicaid
OHFANM02484Medicare PIN