Provider Demographics
NPI:1407295405
Name:PARRISH, SHERRY ANN (AFC PROVIDER)
Entity Type:Individual
Prefix:MS
First Name:SHERRY
Middle Name:ANN
Last Name:PARRISH
Suffix:
Gender:F
Credentials:AFC PROVIDER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:321 CEMETERY RD
Mailing Address - Street 2:
Mailing Address - City:BANGOR
Mailing Address - State:MI
Mailing Address - Zip Code:49013-9541
Mailing Address - Country:US
Mailing Address - Phone:269-427-5033
Mailing Address - Fax:
Practice Address - Street 1:321 CEMETERY RD
Practice Address - Street 2:
Practice Address - City:BANGOR
Practice Address - State:MI
Practice Address - Zip Code:49013-9541
Practice Address - Country:US
Practice Address - Phone:269-427-5033
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-23
Last Update Date:2013-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIAF800087344172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker