Provider Demographics
NPI:1467487629
Name:PARRISH, REBECCA S (NP)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:S
Last Name:PARRISH
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:624 QUAKER LANE
Mailing Address - Street 2:SUITE 100-C
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27262-3832
Mailing Address - Country:US
Mailing Address - Phone:336-878-6027
Mailing Address - Fax:336-878-6189
Practice Address - Street 1:624 QUAKER LANE
Practice Address - Street 2:SUITE 100-C
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27262-3832
Practice Address - Country:US
Practice Address - Phone:336-878-6027
Practice Address - Fax:336-878-6139
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2012-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC041455163W00000X
NC300001363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7000962Medicaid
25903049Medicare ID - Type Unspecified
Q01844Medicare UPIN