Provider Demographics
NPI:1770014458
Name:PARIS, JESSICA (CD)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:PARIS
Suffix:
Gender:F
Credentials:CD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:604 W PEARL ST
Mailing Address - Street 2:
Mailing Address - City:TRAFALGAR
Mailing Address - State:IN
Mailing Address - Zip Code:46181-9712
Mailing Address - Country:US
Mailing Address - Phone:317-494-0741
Mailing Address - Fax:
Practice Address - Street 1:604 W PEARL ST
Practice Address - Street 2:
Practice Address - City:TRAFALGAR
Practice Address - State:IN
Practice Address - Zip Code:46181-9712
Practice Address - Country:US
Practice Address - Phone:317-494-0741
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-23
Last Update Date:2017-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula