Healthcare Provider Details

I. General information

NPI: 1902292402
Provider Name (Legal Business Name): JERRI K. PARSONS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/10/2015
Last Update Date: 04/10/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 JASPER CT
NORTH NEWTON KS
67117-1717
US

IV. Provider business mailing address

PO BOX 504
NORTH NEWTON KS
67117-0504
US

V. Phone/Fax

Practice location:
  • Phone: 316-772-0847
  • Fax:
Mailing address:
  • Phone: 316-772-0847
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number3-06666
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: