Provider Demographics
NPI:1225033103
Name:PARRISH, LILLIE BLAND (NP)
Entity Type:Individual
Prefix:MRS
First Name:LILLIE
Middle Name:BLAND
Last Name:PARRISH
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MRS
Other - First Name:LILLIE
Other - Middle Name:MAE
Other - Last Name:PARRISH
Other - Suffix:III
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:2050 GREAT RIVER CT
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30045-7014
Mailing Address - Country:US
Mailing Address - Phone:770-513-4183
Mailing Address - Fax:
Practice Address - Street 1:3650 STEVE REYNOLDS BLVD
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096-4506
Practice Address - Country:US
Practice Address - Phone:770-931-6107
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-16
Last Update Date:2007-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN052558363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health