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General NPI Number Information
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NPI Number | 1730445719
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Entity Type | Individual
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Provider Name | ANDREA BROOKE PARSONS PA-C
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Gender | Female
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Dates
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Enumeration Date | 04/04/2012
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Last Update Date | 08/02/2023
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Provider Practice Location Address
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Address Line | 8854 W EMERALD ST STE 140
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City | BOISE
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State | ID
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Zip | 83704-4845
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Country | US
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Telephone | 304-590-6490
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 8941
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City | SOUTH CHARLESTON
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State | WV
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Zip | 25303-0941
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Country | US
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Telephone | 304-590-6490
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA9107216
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 2741
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License Number State | WV
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