Provider Demographics
NPI:1851980684
Name:PARRISH, KARISSA (RN)
Entity Type:Individual
Prefix:
First Name:KARISSA
Middle Name:
Last Name:PARRISH
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:KARISSA
Other - Middle Name:
Other - Last Name:JULIETTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12906 HIDDEN VALLEY RANCH RD
Mailing Address - Street 2:
Mailing Address - City:DE SOTO
Mailing Address - State:MO
Mailing Address - Zip Code:63020-4897
Mailing Address - Country:US
Mailing Address - Phone:314-620-5872
Mailing Address - Fax:
Practice Address - Street 1:1055 BOWLES AVE STE 200
Practice Address - Street 2:
Practice Address - City:FENTON
Practice Address - State:MO
Practice Address - Zip Code:63026-2308
Practice Address - Country:US
Practice Address - Phone:636-326-7821
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-15
Last Update Date:2021-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2017035005163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse