MEDICARE: DR. TESSICA HALLIE PARSONS PHARM D

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	183500000X	Pharmacist	16171-040	WI
2	183500000X	Pharmacist	051.294610	IL
3	183500000X	Pharmacist	19855	IA
4	183500000X	Pharmacist	0202206382	VA
5	183500000X	Pharmacist	PH	WA

General Provider Information

NPI Number	:	1922393560
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TESSICA HALLIE PARSONS PHARM D

Provider Business Mailing Address
First Line	:	9777 76TH ST
Second Line	:
City	:	PLEASANT PRAIRIE
State	:	WI
Zip	:	53158-1990
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9777 76TH ST
Second Line	:
City	:	PLEASANT PRAIRIE
State	:	WI
Zip	:	53158-1990
Country	:	US
Telephone Number	:	262-842-1171
Fax Number	:

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

Provider Enumeration Date	:	06/11/2011
Last Update Date	:	06/11/2011

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