Healthcare Provider Details

I. General information

NPI: 1861521783
Provider Name (Legal Business Name): KERRI B PARNELL FNP, PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KERRI M BENNETT

II. Dates (important events)

Enumeration Date: 03/05/2007
Last Update Date: 07/31/2025
Certification Date: 07/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2095 N 4TH ST
WYTHEVILLE VA
24382-4411
US

IV. Provider business mailing address

770 W RIDGE RD
WYTHEVILLE VA
24382-1187
US

V. Phone/Fax

Practice location:
  • Phone: 276-228-7069
  • Fax: 276-228-5375
Mailing address:
  • Phone: 276-223-3200
  • Fax: 276-223-0617

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024180398
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: