Healthcare Provider Details

I. General information

NPI: 1053474023
Provider Name (Legal Business Name): GEEIA PARRIS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/19/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 COCHISE DR
WINSLOW AZ
86047-2072
US

IV. Provider business mailing address

100 COCHISE DR
WINSLOW AZ
86047-2072
US

V. Phone/Fax

Practice location:
  • Phone: 928-288-8415
  • Fax: 928-288-8492
Mailing address:
  • Phone: 928-288-8415
  • Fax: 928-288-8492

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License NumberRN128319
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: