Individual
ELISSA NOEL FARMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.-C
Contact information
Practice address
645 AMALIA STREET, NE, CONCORD, NC 28025-2434
(704) 295-3255
(704) 295-3279
Mailing address
6035 FAIRVIEW RD, CHARLOTTE, NC 28210-3256
(704) 295-3000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
103664
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1251PA
—
SC
01
—
164XG
BCBSNC
NC
01
—
7125423
AETNA
—
05
—
8102401
—
NC
01
—
833405
WELLCARE
SC
01
—
P01131698
MEDICARE - RAILROAD
NC
Enumeration date
06/12/2006
Last updated
02/16/2015
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