Healthcare Provider Details

I. General information

NPI: 1538039235
Provider Name (Legal Business Name): MISS ABBYGAYLE NICOLE PARSHALL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/07/2025
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4669 E 8 MILE RD
WARREN MI
48091-2709
US

IV. Provider business mailing address

4669 E 8 MILE RD
WARREN MI
48091-2709
US

V. Phone/Fax

Practice location:
  • Phone: 313-416-6262
  • Fax:
Mailing address:
  • Phone: 313-416-6262
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: