Individual
MISS STACY L FARLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
700 S PARK ST, MADISON, WI 53715-1830
(800) 680-4369
Mailing address
700 S PARK ST, MADISON, WI 53715-1830
(800) 680-4369
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
085.003773
IL
363A00000X
Physician Assistant
Primary
3038-23
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1255643417
—
WI
Enumeration date
07/05/2010
Last updated
03/12/2024
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