Provider Demographics
NPI:1407992449
Name:PARISO, DEBORAH ANN (CNS)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:ANN
Last Name:PARISO
Suffix:
Gender:F
Credentials:CNS
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:ANN
Other - Last Name:PARISO BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNS
Mailing Address - Street 1:1433 HIGHLAND PKWY
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55116-2240
Mailing Address - Country:US
Mailing Address - Phone:651-698-1150
Mailing Address - Fax:651-698-0455
Practice Address - Street 1:1433 HIGHLAND PKWY
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55116-2240
Practice Address - Country:US
Practice Address - Phone:651-698-1150
Practice Address - Fax:651-698-0455
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR079426364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNP47216Medicare UPIN