Healthcare Provider Details

I. General information

NPI: 1821783325
Provider Name (Legal Business Name): MICHAEL BRIAN PARR DNP, PMHNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/10/2023
Last Update Date: 04/10/2023
Certification Date: 01/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

702 N 13TH ST
ARTESIA NM
88210-1166
US

IV. Provider business mailing address

2309 TERRACE CT
LAS CRUCES NM
88011-5065
US

V. Phone/Fax

Practice location:
  • Phone: 575-736-8127
  • Fax: 575-748-8549
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number72462
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: