Provider Demographics
NPI:1396426607
Name:FARLEY, ALEKE YAZMINE-ABDULLAH
Entity type:Individual
Prefix:
First Name:ALEKE
Middle Name:YAZMINE-ABDULLAH
Last Name:FARLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3020 CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:EAST POINT
Mailing Address - State:GA
Mailing Address - Zip Code:30344-4205
Mailing Address - Country:US
Mailing Address - Phone:404-449-1263
Mailing Address - Fax:
Practice Address - Street 1:2910 EVANS MILL RD
Practice Address - Street 2:
Practice Address - City:LITHONIA
Practice Address - State:GA
Practice Address - Zip Code:30038-2481
Practice Address - Country:US
Practice Address - Phone:678-508-1935
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-28
Last Update Date:2023-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN239681163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health