Provider Demographics
NPI:1124865100
Name:FARRIS, FAITH (PA)
Entity type:Individual
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First Name:FAITH
Middle Name:
Last Name:FARRIS
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Gender:
Credentials:PA
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Mailing Address - Street 1:1306 CONCOURSE DR STE 201
Mailing Address - Street 2:
Mailing Address - City:LINTHICUM HEIGHTS
Mailing Address - State:MD
Mailing Address - Zip Code:21090-1033
Mailing Address - Country:US
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Mailing Address - Fax:
Practice Address - Street 1:5272 OCEAN HWY W
Practice Address - Street 2:
Practice Address - City:SHALLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28470-4006
Practice Address - Country:US
Practice Address - Phone:910-251-9944
Practice Address - Fax:910-763-4666
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-09
Last Update Date:2025-02-18
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant