Provider Demographics
NPI:1265032015
Name:PARSON, DOROTHY ANGELA (LPN)
Entity Type:Individual
Prefix:
First Name:DOROTHY
Middle Name:ANGELA
Last Name:PARSON
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 HILLSBOROUGH DR APT 54
Mailing Address - Street 2:
Mailing Address - City:SENECA
Mailing Address - State:SC
Mailing Address - Zip Code:29678-3762
Mailing Address - Country:US
Mailing Address - Phone:864-557-2779
Mailing Address - Fax:
Practice Address - Street 1:1000 HILLSBOROUGH DR APT 54
Practice Address - Street 2:
Practice Address - City:SENECA
Practice Address - State:SC
Practice Address - Zip Code:29678-3762
Practice Address - Country:US
Practice Address - Phone:864-557-2779
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-30
Last Update Date:2020-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC51978164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse