Healthcare Provider Details

I. General information

NPI: 1245348689
Provider Name (Legal Business Name): NANCI W PARISH FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2006
Last Update Date: 05/13/2021
Certification Date: 05/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1702 A HWY 11 NORTH
PICAYUNE MS
39466-0419
US

IV. Provider business mailing address

5959 S SHERWOOD FOREST BLVD
BATON ROUGE LA
70816-6038
US

V. Phone/Fax

Practice location:
  • Phone: 601-799-3130
  • Fax: 601-799-3132
Mailing address:
  • Phone: 225-765-5727
  • Fax: 225-765-9691

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR619442
License Number StateMS
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number619442
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: