Healthcare Provider Details

I. General information

NPI: 1528578614
Provider Name (Legal Business Name): MISTIE DAWN PARRISH RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2017
Last Update Date: 10/03/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

645 RODI RD
PITTSBURGH PA
15235-4564
US

IV. Provider business mailing address

302 SOUTH ST
BERLIN PA
15530-1223
US

V. Phone/Fax

Practice location:
  • Phone: 866-878-5301
  • Fax:
Mailing address:
  • Phone: 814-233-0251
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License NumberRN663502
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: