Provider Demographics
NPI:1639539125
Name:PARENT, MARIE-ANDREE (NP)
Entity Type:Individual
Prefix:
First Name:MARIE-ANDREE
Middle Name:
Last Name:PARENT
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6296 CHEATHAM LAKE DR NW
Mailing Address - Street 2:
Mailing Address - City:ACWORTH
Mailing Address - State:GA
Mailing Address - Zip Code:30101-7642
Mailing Address - Country:US
Mailing Address - Phone:516-647-1557
Mailing Address - Fax:678-398-9708
Practice Address - Street 1:6296 CHEATHAM LAKE DR NW
Practice Address - Street 2:
Practice Address - City:ACWORTH
Practice Address - State:GA
Practice Address - Zip Code:30101-7642
Practice Address - Country:US
Practice Address - Phone:516-647-1557
Practice Address - Fax:678-398-9708
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-26
Last Update Date:2021-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN186804163WG0000X, 363LP0808X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health