Provider Demographics
NPI:1356331268
Name:PARNELL, JOHN DAVID (CRNA)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:DAVID
Last Name:PARNELL
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 660685
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35266-0685
Mailing Address - Country:US
Mailing Address - Phone:205-979-5882
Mailing Address - Fax:205-979-1248
Practice Address - Street 1:1720 UNIVERSITY BLVD
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35233-1816
Practice Address - Country:US
Practice Address - Phone:205-325-8387
Practice Address - Fax:205-325-8594
Is Sole Proprietor?:No
Enumeration Date:2005-10-24
Last Update Date:2013-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN117376367500000X
AL1-134813367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3633323Medicaid
TN4076439OtherBLUE CROSS BLUE SHIELD
TN4076439OtherBLUE CROSS BLUE SHIELD
TN3633323Medicaid