Provider Demographics
NPI:1811595747
Name:PARSONS, JENNIFER NICHOLE (LAC)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:NICHOLE
Last Name:PARSONS
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:512 RIVERSIDE PKWY NE STE 702
Mailing Address - Street 2:
Mailing Address - City:ROME
Mailing Address - State:GA
Mailing Address - Zip Code:30161-2910
Mailing Address - Country:US
Mailing Address - Phone:706-978-6220
Mailing Address - Fax:877-701-1897
Practice Address - Street 1:512 RIVERSIDE PKWY NE
Practice Address - Street 2:
Practice Address - City:ROME
Practice Address - State:GA
Practice Address - Zip Code:30161-2911
Practice Address - Country:US
Practice Address - Phone:706-978-6220
Practice Address - Fax:877-701-1897
Is Sole Proprietor?:No
Enumeration Date:2020-10-13
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA475171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist