Provider Demographics
NPI:1508435850
Name:PARSLEY, JENNIFER RENEA
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:RENEA
Last Name:PARSLEY
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 1:3500 OLD LOGAN RD
Mailing Address - Street 2:
Mailing Address - City:LOGAN
Mailing Address - State:WV
Mailing Address - Zip Code:25601-3071
Mailing Address - Country:US
Mailing Address - Phone:304-785-6817
Mailing Address - Fax:
Practice Address - Street 1:224 MOUNTAIN RIDGE RD.
Practice Address - Street 2:
Practice Address - City:MT. GAY
Practice Address - State:WV
Practice Address - Zip Code:25637
Practice Address - Country:US
Practice Address - Phone:304-239-3872
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-22
Last Update Date:2021-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant