Provider Demographics
NPI:1598082240
Name:PARRIS, KARINA
Entity Type:Individual
Prefix:
First Name:KARINA
Middle Name:
Last Name:PARRIS
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 1:18347 SHAY RD
Mailing Address - Street 2:
Mailing Address - City:VICTORVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:92394-9539
Mailing Address - Country:US
Mailing Address - Phone:760-245-5673
Mailing Address - Fax:760-245-5673
Practice Address - Street 1:18347 SHAY RD
Practice Address - Street 2:
Practice Address - City:VICTORVILLE
Practice Address - State:CA
Practice Address - Zip Code:92394-9539
Practice Address - Country:US
Practice Address - Phone:760-245-5673
Practice Address - Fax:760-245-5673
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-20
Last Update Date:2010-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver