Healthcare Provider Details

I. General information

NPI: 1518128180
Provider Name (Legal Business Name): TRACY LYNN PARRISH MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/17/2008
Last Update Date: 09/02/2024
Certification Date: 09/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 MILTON BROWN HEIRS RD
BOONE NC
28607-8708
US

IV. Provider business mailing address

902 KIRKWOOD AVE NW
LENOIR NC
28645-5121
US

V. Phone/Fax

Practice location:
  • Phone: 828-264-6720
  • Fax:
Mailing address:
  • Phone: 828-754-0101
  • Fax: 828-757-0402

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number2010-00398
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code207PH0002X
TaxonomyHospice and Palliative Medicine (Emergency Medicine) Physician
License Number2010-00398
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number149358
License Number StateNC
# 4
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number2010-00398
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: