Provider Demographics
NPI:1285211458
Name:PARSONS, KEELEY
Entity Type:Individual
Prefix:
First Name:KEELEY
Middle Name:
Last Name:PARSONS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1511 CRESCENT ST
Mailing Address - Street 2:
Mailing Address - City:PARKERSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:26101-6915
Mailing Address - Country:US
Mailing Address - Phone:304-966-3758
Mailing Address - Fax:
Practice Address - Street 1:1511 CRESCENT ST
Practice Address - Street 2:
Practice Address - City:PARKERSBURG
Practice Address - State:WV
Practice Address - Zip Code:26101-6915
Practice Address - Country:US
Practice Address - Phone:304-966-3758
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-25
Last Update Date:2021-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker