Kecia K Farley, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

10643992-4405 Issued in UT

Practice address

2355 Highway 36 W
Roseville, MN 55113-3902

Phone

(810) 471-8522

NPI assigned

Aug 12, 2021

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: kecia.farley@811393367080964.direct.elationemr.com

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1628726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628726400000",
    "number": "1013682970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1065 W BLUE MOUNTAIN RD",
            "city": "WASHINGTON",
            "state": "UT",
            "postal_code": "847801325",
            "telephone_number": "801-471-8522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2355 HIGHWAY 36 W",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551133902",
            "telephone_number": "810-471-8522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARLEY",
        "first_name": "KECIA",
        "middle_name": "K",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-12",
        "last_updated": "2021-08-12",
        "certification_date": "2021-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "10643992-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Roseville, MN
• Family Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.