Healthcare Provider Details

I. General information

NPI: 1366263360
Provider Name (Legal Business Name): TONI PARRIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/22/2024
Last Update Date: 10/22/2024
Certification Date: 10/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

968 BETTY LN
FRANKLIN IN
46131-9265
US

IV. Provider business mailing address

968 BETTY LN
FRANKLIN IN
46131-9265
US

V. Phone/Fax

Practice location:
  • Phone: 317-519-7168
  • Fax:
Mailing address:
  • Phone: 317-519-7168
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License Number28171362A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: