Provider Demographics
NPI:1558707885
Name:PARNELL, JODY MELISSA (RN)
Entity Type:Individual
Prefix:MRS
First Name:JODY
Middle Name:MELISSA
Last Name:PARNELL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 118
Mailing Address - Street 2:
Mailing Address - City:IVA
Mailing Address - State:SC
Mailing Address - Zip Code:29655-0118
Mailing Address - Country:US
Mailing Address - Phone:864-348-6196
Mailing Address - Fax:864-348-6198
Practice Address - Street 1:400 PROFESSOR BROWN LN
Practice Address - Street 2:
Practice Address - City:STARR
Practice Address - State:SC
Practice Address - Zip Code:29684-9506
Practice Address - Country:US
Practice Address - Phone:864-352-6154
Practice Address - Fax:864-352-6158
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-14
Last Update Date:2013-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC61046163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool