Healthcare Provider Details

I. General information

NPI: 1851899199
Provider Name (Legal Business Name): DR. JAN PARRISH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/31/2018
Last Update Date: 01/31/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3820 NINE MILE RD
RICHMOND VA
23223-4831
US

IV. Provider business mailing address

3820 NINE MILE RD
RICHMOND VA
23223-4831
US

V. Phone/Fax

Practice location:
  • Phone: 804-343-6500
  • Fax:
Mailing address:
  • Phone: 804-343-6500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License NumberPPS-340354
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: