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General NPI Number Information
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NPI Number | 1265788434
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Entity Type | Individual
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Provider Name | JENNIFER SUE PARRETTE NP
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Gender | Female
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Dates
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Enumeration Date | 07/25/2012
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Last Update Date | 01/11/2022
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Provider Practice Location Address
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Address Line | 769 PIPESTONE ST
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City | BENTON HARBOR
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State | MI
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Zip | 49022-4815
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Country | US
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Telephone | 269-926-7121
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Fax |
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Provider Business Mailing Address
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Address Line | 1253 S 500 W
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City | LA PORTE
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State | IN
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Zip | 46350-9760
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Country | US
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Telephone | 219-362-1817
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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 | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | 4704200141
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License Number State | MI
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