Provider Demographics
NPI:1609176833
Name:MOORE, PATRICIA FARLEY (MAE)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:FARLEY
Last Name:MOORE
Suffix:
Gender:F
Credentials:MAE
Other - Prefix:MISS
Other - First Name:PATRICIA
Other - Middle Name:LYNNE
Other - Last Name:FARLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:343 WALLER AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40504-2912
Mailing Address - Country:US
Mailing Address - Phone:859-271-9448
Mailing Address - Fax:272-689-3291
Practice Address - Street 1:343 WALLER AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40504-2912
Practice Address - Country:US
Practice Address - Phone:859-271-9448
Practice Address - Fax:272-689-3291
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-21
Last Update Date:2010-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator