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NPI Code Detail

MEDICARE: MRS. PATRICIA M PARRISH NP

MEDICARE: MRS. PATRICIA M PARRISH NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse PractitionerRN066656GA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1500002323OTHERGARAILROAD MEDICARE
3CB5821OTHERGAMEDICARE ID TYPE UNSPECIFIED

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1053310433
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. PATRICIA M PARRISH NP
Provider Business Mailing Address
First Line : 907 18TH ST E
Second Line : SUITE 150
City : TIFTON
State : GA
Zip : 31794-3643
Country : US
Telephone Number : 229-353-3422
Fax Number :
Provider Business Practice Location Address
First Line : 901 18TH ST E
Second Line :
City : TIFTON
State : GA
Zip : 31794-3648
Country : US
Telephone Number : 229-382-7120
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/19/2005
Last Update Date : 06/18/2015

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Directions to “ MRS. PATRICIA M PARRISH NP” Practice Location

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