Provider Demographics
NPI:1780182121
Name:PARRISH, CRYSTAL LATRICE (RN)
Entity Type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:LATRICE
Last Name:PARRISH
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 210031
Mailing Address - Street 2:
Mailing Address - City:SOUTH EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44121-7031
Mailing Address - Country:US
Mailing Address - Phone:216-533-9818
Mailing Address - Fax:
Practice Address - Street 1:3376 SEATON RD
Practice Address - Street 2:
Practice Address - City:CLEVELAND HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44118-1334
Practice Address - Country:US
Practice Address - Phone:216-533-9818
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-31
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN-344061163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse