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General NPI Number Information
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NPI Number | 1083873673
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Entity Type | Individual
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Provider Name | STEFANI NIKE PARRISBALOGUN M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/09/2008
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Last Update Date | 05/18/2018
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Provider Practice Location Address
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Address Line | 10524 EUCLID AVE
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City | CLEVELAND
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State | OH
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Zip | 44106
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Country | US
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Telephone | 216-844-2400
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Fax |
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Provider Business Mailing Address
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Address Line | 121 LUNA LN
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City | HENDERSONVILLE
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State | TN
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Zip | 37075-4422
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 35091174
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 35091174
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 4301106892
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License Number State | MI
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Taxonomy #4
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 55654
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License Number State | TN
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