Healthcare Provider Details

I. General information

NPI: 1962597948
Provider Name (Legal Business Name): M WHITNEY PARNELL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2960 E ST LUKES RD SUITE 200
MERIDIAN ID
83642
US

IV. Provider business mailing address

PO BOX 4083
BOISE ID
83711-4083
US

V. Phone/Fax

Practice location:
  • Phone: 986-224-9576
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMC-0383
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: