Healthcare Provider Details

I. General information

NPI: 1023419793
Provider Name (Legal Business Name): TERESA GAYLE PARSONS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/11/2014
Last Update Date: 10/02/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

151 W 7TH AVE STE 263
EUGENE OR
97401-2676
US

IV. Provider business mailing address

2073 OLYMPIC ST
SPRINGFIELD OR
97477-3413
US

V. Phone/Fax

Practice location:
  • Phone: 541-682-4041
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number079042362RN
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License Number079042362RN
License Number StateOR
# 3
Primary TaxonomyY
Taxonomy Code163WA2000X
TaxonomyAdministrator Registered Nurse
License Number079042362RN
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: