Provider Demographics
NPI:1235695602
Name:PARRISH, LAUREN (MS, RD, CSCS)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:PARRISH
Suffix:
Gender:F
Credentials:MS, RD, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:916 N OAK TER
Mailing Address - Street 2:
Mailing Address - City:TONGANOXIE
Mailing Address - State:KS
Mailing Address - Zip Code:66086-4504
Mailing Address - Country:US
Mailing Address - Phone:641-799-9048
Mailing Address - Fax:
Practice Address - Street 1:16979 W 94TH ST STE D
Practice Address - Street 2:
Practice Address - City:LENEXA
Practice Address - State:KS
Practice Address - Zip Code:66219-1939
Practice Address - Country:US
Practice Address - Phone:641-799-9048
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-11
Last Update Date:2019-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2205133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered