Provider Demographics
NPI:1649586504
Name:PARRENT, STACEY DARLENE (LPN)
Entity Type:Individual
Prefix:MRS
First Name:STACEY
Middle Name:DARLENE
Last Name:PARRENT
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:STACEY
Other - Middle Name:D
Other - Last Name:HUSTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2818 WILLOW AVE
Mailing Address - Street 2:
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57701-7240
Mailing Address - Country:US
Mailing Address - Phone:605-786-7106
Mailing Address - Fax:
Practice Address - Street 1:2818 WILLOW AVE
Practice Address - Street 2:
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57701-7240
Practice Address - Country:US
Practice Address - Phone:605-786-7106
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-28
Last Update Date:2010-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDP010406164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse