Provider Demographics
NPI:1174286207
Name:PARMLEY, TINA RACHELL (RN,BSN)
Entity Type:Individual
Prefix:
First Name:TINA
Middle Name:RACHELL
Last Name:PARMLEY
Suffix:
Gender:F
Credentials:RN,BSN
Other - Prefix:
Other - First Name:TINA
Other - Middle Name:R
Other - Last Name:PARMLEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN,BSN
Mailing Address - Street 1:1000 PINEGATE DR APT D73
Mailing Address - Street 2:
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29303-6215
Mailing Address - Country:US
Mailing Address - Phone:843-698-9528
Mailing Address - Fax:
Practice Address - Street 1:151 E WOOD ST
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29303-3016
Practice Address - Country:US
Practice Address - Phone:864-596-2227
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-15
Last Update Date:2021-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC107713163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health