Provider Demographics
NPI:1447736293
Name:PARRISH, PHYLLIS N
Entity Type:Individual
Prefix:
First Name:PHYLLIS
Middle Name:N
Last Name:PARRISH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10506 INNISBROOK DR
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32222-1363
Mailing Address - Country:US
Mailing Address - Phone:904-504-6944
Mailing Address - Fax:
Practice Address - Street 1:10506 INNISBROOK DR
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32222
Practice Address - Country:US
Practice Address - Phone:904-504-6944
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-16
Last Update Date:2018-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376K00000XNursing Service Related ProvidersNurse's AideGroup - Multi-Specialty
No374U00000XNursing Service Related ProvidersHome Health Aide