Provider Demographics
NPI:1790087112
Name:FARLEY, ANDI CARROLL (MSN,WHNP)
Entity Type:Individual
Prefix:
First Name:ANDI
Middle Name:CARROLL
Last Name:FARLEY
Suffix:
Gender:F
Credentials:MSN,WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 55310
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35255-5310
Mailing Address - Country:US
Mailing Address - Phone:205-731-9701
Mailing Address - Fax:
Practice Address - Street 1:1500 6TH AVE S
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35233-1602
Practice Address - Country:US
Practice Address - Phone:205-934-2170
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-18
Last Update Date:2023-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1100927363LW0102X
AL1-100927363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051113236OtherBCBS
AL051113238OtherBCBS
ALZ50042OtherVIVA
AL135042Medicaid
AL051113240OtherBCBS
AL135023Medicaid
AL135038Medicaid
AL135024Medicaid
AL135043Medicaid
AL135045Medicaid
AL051113235OtherBCBS
AL051113239OtherBCBS
AL135039Medicaid
AL051113242OtherBCBS
MS07702747Medicaid
AL135046Medicaid
AL051113232OtherBCBS
AL051113233OtherBCBS
AL051113237OtherBCBS
AL135040Medicaid
AL102I504544Medicare PIN