Provider Demographics
NPI:1942907001
Name:PARRISH, TRACY ANN
Entity Type:Individual
Prefix:
First Name:TRACY
Middle Name:ANN
Last Name:PARRISH
Suffix:
Gender:F
Credentials:
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 686
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59624-0686
Mailing Address - Country:US
Mailing Address - Phone:406-202-8788
Mailing Address - Fax:
Practice Address - Street 1:2801 COLONIAL DR APT 203
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601-8040
Practice Address - Country:US
Practice Address - Phone:406-202-8788
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-09
Last Update Date:2023-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT45780058253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care