Provider Demographics
NPI:1992380604
Name:PARRA, OKIEMUTE (RN)
Entity Type:Individual
Prefix:
First Name:OKIEMUTE
Middle Name:
Last Name:PARRA
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 1:1400 LENTON ROSE CT
Mailing Address - Street 2:
Mailing Address - City:TRINITY
Mailing Address - State:FL
Mailing Address - Zip Code:34655-4994
Mailing Address - Country:US
Mailing Address - Phone:727-460-2123
Mailing Address - Fax:
Practice Address - Street 1:694 CANTERBURY RD
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33764-6327
Practice Address - Country:US
Practice Address - Phone:727-460-2123
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-15
Last Update Date:2021-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9284976163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse