Healthcare Provider Details

I. General information

NPI: 1245169192
Provider Name (Legal Business Name): COURTNEY M PARRISH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 NE 13TH ST # 1G
OKLAHOMA CITY OK
73104-5040
US

IV. Provider business mailing address

10424 SW 40TH ST
MUSTANG OK
73064-9087
US

V. Phone/Fax

Practice location:
  • Phone: 405-271-8478
  • Fax:
Mailing address:
  • Phone: 580-678-9003
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number207779
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: