Healthcare Provider Details

I. General information

NPI: 1669079604
Provider Name (Legal Business Name): JESSICA YVONNE PARHAM REGISTERED NURSE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/02/2020
Last Update Date: 07/12/2025
Certification Date: 07/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2501 SPRING ST # A
PITTSBURGH PA
15210-2630
US

IV. Provider business mailing address

779 STANLEY AVE
COLUMBUS OH
43206-2438
US

V. Phone/Fax

Practice location:
  • Phone: 937-972-1932
  • Fax:
Mailing address:
  • Phone: 614-822-1144
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WA0400X
TaxonomyAddiction (Substance Use Disorder) Registered Nurse
License Number398311
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number398311
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number398311
License Number StateOH
# 4
Primary TaxonomyN
Taxonomy Code374J00000X
TaxonomyDoula
License Number398311
License Number StateOH
# 5
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number398311
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: