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Individual
MRS. TONYA M FARLESS
Active
Individual
MRS. TONYA M FARLESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1072
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0391PA
—
SC
01
—
1069402
NCCPA
SC
01
—
AA1344A634
MEDICARE PTAN
SC
Enumeration date
06/06/2006
Last updated
02/09/2026
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