Healthcare Provider Details

I. General information

NPI: 1700596293
Provider Name (Legal Business Name): KEVIN NICHOLAS PARSONS LPN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/25/2022
Last Update Date: 11/25/2022
Certification Date: 11/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 VIRGINIA ST E STE 400
CHARLESTON WV
25301-2835
US

IV. Provider business mailing address

329 BAUMGARTNER AVE # A
OAK HILL WV
25901-2196
US

V. Phone/Fax

Practice location:
  • Phone: 681-313-4759
  • Fax: 844-800-3954
Mailing address:
  • Phone: 304-622-2134
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number35971
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: