Provider Demographics
NPI:1649418096
Name:PARSHALL, MARK B (PHD, RN)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:B
Last Name:PARSHALL
Suffix:
Gender:M
Credentials:PHD, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2502 MARBLE AVE NE
Mailing Address - Street 2:MSC 09 5350 1 UNIVERSITY OF NEW MEXICO
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87131-0001
Mailing Address - Country:US
Mailing Address - Phone:505-272-4540
Mailing Address - Fax:505-272-8901
Practice Address - Street 1:2502 MARBLE AVE NE
Practice Address - Street 2:MSC 09 5350 1 UNIVERSITY OF NEW MEXICO
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87131-0001
Practice Address - Country:US
Practice Address - Phone:505-272-4540
Practice Address - Fax:505-272-8901
Is Sole Proprietor?:No
Enumeration Date:2009-01-22
Last Update Date:2009-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMR24679163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse