Provider Demographics
NPI:1629650122
Name:PARSHALL, SANDRA K (CNA)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:K
Last Name:PARSHALL
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 SHERRON DR
Mailing Address - Street 2:
Mailing Address - City:DICKSON
Mailing Address - State:TN
Mailing Address - Zip Code:37055-1147
Mailing Address - Country:US
Mailing Address - Phone:615-238-1599
Mailing Address - Fax:
Practice Address - Street 1:120 SHERRON DR
Practice Address - Street 2:
Practice Address - City:DICKSON
Practice Address - State:TN
Practice Address - Zip Code:37055-1147
Practice Address - Country:US
Practice Address - Phone:615-238-1599
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-23
Last Update Date:2021-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN00164422376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide