Provider Demographics
NPI:1205532678
Name:FARLEY, KRISHON L (CD, CLC)
Entity type:Individual
Prefix:MRS
First Name:KRISHON
Middle Name:L
Last Name:FARLEY
Suffix:
Gender:F
Credentials:CD, CLC
Other - Prefix:MRS
Other - First Name:KRIS
Other - Middle Name:
Other - Last Name:ELLE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CD, CLC
Mailing Address - Street 1:14311 REESE BLVD STE A2
Mailing Address - Street 2:#353
Mailing Address - City:HUNTERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28078-7955
Mailing Address - Country:US
Mailing Address - Phone:310-855-2590
Mailing Address - Fax:
Practice Address - Street 1:12505 PICKFORD CT
Practice Address - Street 2:
Practice Address - City:HUNTERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28078-8132
Practice Address - Country:US
Practice Address - Phone:310-855-2590
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-06
Last Update Date:2023-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula