Provider Demographics
NPI:1407149776
Name:PARRAM, MARCHICA TERRELL (CSA)
Entity Type:Individual
Prefix:MR
First Name:MARCHICA
Middle Name:TERRELL
Last Name:PARRAM
Suffix:
Gender:F
Credentials:CSA
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 34162
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38184-0162
Mailing Address - Country:US
Mailing Address - Phone:901-239-1124
Mailing Address - Fax:
Practice Address - Street 1:5157 PATRICK HENRY DR
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38134-2906
Practice Address - Country:US
Practice Address - Phone:901-239-1124
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-19
Last Update Date:2014-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
246ZS0410X
TN3681246ZS0410X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Technologist