Provider Demographics
NPI:1689063349
Name:PARRISH, TRACIE LYNN (APRN)
Entity Type:Individual
Prefix:
First Name:TRACIE
Middle Name:LYNN
Last Name:PARRISH
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
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Mailing Address - Street 1:4071 TATES CREEK CENTRE DR
Mailing Address - Street 2:202
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40517-3062
Mailing Address - Country:US
Mailing Address - Phone:859-971-4665
Mailing Address - Fax:859-971-4604
Practice Address - Street 1:60 S STEWART RD
Practice Address - Street 2:
Practice Address - City:CORBIN
Practice Address - State:KY
Practice Address - Zip Code:40701-4675
Practice Address - Country:US
Practice Address - Phone:606-528-9770
Practice Address - Fax:606-528-9769
Is Sole Proprietor?:No
Enumeration Date:2015-01-20
Last Update Date:2015-01-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KY3009055363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner