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Individual

KIM L FARLEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PAFA

Contact information

Practice address
489 STATE ST, BANGOR, ME 04401-6616
(207) 947-6508
(207) 941-8342
Mailing address
29 SURREY LN, HAMPDEN, ME 04444-1414
(207) 862-5505

Taxonomy

Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
Primary
R024428
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
25765
ANTHEM
Enumeration date
09/05/2008
Last updated
06/11/2012
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