Provider Demographics
NPI:1922215284
Name:FARLEY, DEBORAH LEA (ARNP)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:LEA
Last Name:FARLEY
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 S LYNN LN
Mailing Address - Street 2:
Mailing Address - City:IDABEL
Mailing Address - State:OK
Mailing Address - Zip Code:74745-6858
Mailing Address - Country:US
Mailing Address - Phone:580-286-6628
Mailing Address - Fax:580-286-2012
Practice Address - Street 1:1400 S LYNN LN
Practice Address - Street 2:
Practice Address - City:IDABEL
Practice Address - State:OK
Practice Address - Zip Code:74745-6858
Practice Address - Country:US
Practice Address - Phone:580-286-6628
Practice Address - Fax:580-286-2012
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0031310363LC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LC1500XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCommunity Health