Healthcare Provider Details

I. General information

NPI: 1770298580
Provider Name (Legal Business Name): CHRISTY LYNN PARSON FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/16/2023
Last Update Date: 01/16/2023
Certification Date: 01/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

740 COMMERCE DR STE A
PERRYSBURG OH
43551-5276
US

IV. Provider business mailing address

3574 MELROSE DR UNIT O3
WOOSTER OH
44691-5595
US

V. Phone/Fax

Practice location:
  • Phone: 855-259-9183
  • Fax:
Mailing address:
  • Phone: 330-904-9367
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.0031169
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: