MEDICARE: JEAN-MARI PARSONS LAT, ATC

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
1	2255A2300X	Athletic Trainer	LAT-5764	NC

General Provider Information

NPI Number	:	1689130411
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEAN-MARI PARSONS LAT, ATC

Provider Business Mailing Address
First Line	:	801 TULSA CT
Second Line	:
City	:	FAYETTEVILLE
State	:	NC
Zip	:	28311-1157
Country	:	US
Telephone Number	:	936-524-8326
Fax Number	:

Provider Business Practice Location Address
First Line	:	2416 KEERANS STREET
Second Line	:
City	:	FORT BRAGG
State	:	NC
Zip	:	28310-8207
Country	:	US
Telephone Number	:	936-524-8326
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/18/2019
Last Update Date	:	01/07/2026

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