Provider Demographics
NPI:1376157099
Name:PARVIN, KATHRYN TAYLOR (NP-C)
Entity Type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:TAYLOR
Last Name:PARVIN
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 CANDLEWOOD CT
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MS
Mailing Address - Zip Code:39046-4500
Mailing Address - Country:US
Mailing Address - Phone:601-551-5181
Mailing Address - Fax:
Practice Address - Street 1:969 LAKELAND DR
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39216-4699
Practice Address - Country:US
Practice Address - Phone:601-200-2000
Practice Address - Fax:601-362-7694
Is Sole Proprietor?:No
Enumeration Date:2020-09-01
Last Update Date:2020-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS9038672085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology