Provider Demographics
NPI:1942606868
Name:FARLEY, ROBIN ELIZABETH (OPA-C, SA-C)
Entity Type:Individual
Prefix:MRS
First Name:ROBIN
Middle Name:ELIZABETH
Last Name:FARLEY
Suffix:
Gender:F
Credentials:OPA-C, SA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:621 SUNRISE ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:IA
Mailing Address - Zip Code:50622
Mailing Address - Country:US
Mailing Address - Phone:319-404-9271
Mailing Address - Fax:
Practice Address - Street 1:1753 W RIDGEWAY AVE
Practice Address - Street 2:SUITE103B
Practice Address - City:WATERLOO
Practice Address - State:IA
Practice Address - Zip Code:50701-4544
Practice Address - Country:US
Practice Address - Phone:319-833-5922
Practice Address - Fax:319-833-5923
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-05
Last Update Date:2014-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant