Provider Demographics
NPI:1932464542
Name:PARRISH, HEATH JACKSON (FNP-C)
Entity Type:Individual
Prefix:
First Name:HEATH
Middle Name:JACKSON
Last Name:PARRISH
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:190 DEERWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:FITZGERALD
Mailing Address - State:GA
Mailing Address - Zip Code:31750-6511
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:110 NORMAN DORMINY DR STE A
Practice Address - Street 2:
Practice Address - City:FITZGERALD
Practice Address - State:GA
Practice Address - Zip Code:31750-8858
Practice Address - Country:US
Practice Address - Phone:229-409-0874
Practice Address - Fax:229-409-0877
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-10
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN176061363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care