Provider Demographics
NPI:1639466972
Name:PARRA, BEN (RN)
Entity Type:Individual
Prefix:
First Name:BEN
Middle Name:
Last Name:PARRA
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:BEN
Other - Middle Name:
Other - Last Name:PARRA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:321 S SHIPP ST
Mailing Address - Street 2:
Mailing Address - City:HOBBS
Mailing Address - State:NM
Mailing Address - Zip Code:88240-6501
Mailing Address - Country:US
Mailing Address - Phone:575-704-0880
Mailing Address - Fax:
Practice Address - Street 1:321 S SHIPP ST
Practice Address - Street 2:
Practice Address - City:HOBBS
Practice Address - State:NM
Practice Address - Zip Code:88240-6501
Practice Address - Country:US
Practice Address - Phone:575-704-0880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-07
Last Update Date:2011-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM03-219828-00-0343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)