Provider Demographics
NPI:1114600830
Name:PARR, LAURYN ASHLEIGH
Entity Type:Individual
Prefix:MS
First Name:LAURYN
Middle Name:ASHLEIGH
Last Name:PARR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LAURYN
Other - Middle Name:ASHLEIGH
Other - Last Name:PARR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:206 W 5TH ST
Mailing Address - Street 2:
Mailing Address - City:METROPOLIS
Mailing Address - State:IL
Mailing Address - Zip Code:62960-1810
Mailing Address - Country:US
Mailing Address - Phone:618-524-9368
Mailing Address - Fax:
Practice Address - Street 1:206 W 5TH ST
Practice Address - Street 2:
Practice Address - City:METROPOLIS
Practice Address - State:IL
Practice Address - Zip Code:62960-1810
Practice Address - Country:US
Practice Address - Phone:618-524-9368
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-09
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist