Provider Demographics
NPI:1184957797
Name:PARMAN, SALLY A (RN)
Entity type:Individual
Prefix:MRS
First Name:SALLY
Middle Name:A
Last Name:PARMAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MRS
Other - First Name:SALLY
Other - Middle Name:A
Other - Last Name:PARMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PMHCNS-BC
Mailing Address - Street 1:415 N 26TH ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:LAFAYETTE
Mailing Address - State:IN
Mailing Address - Zip Code:47904-2856
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:415 N 26TH ST
Practice Address - Street 2:SUITE 201
Practice Address - City:LAFAYETTE
Practice Address - State:IN
Practice Address - Zip Code:47904-2856
Practice Address - Country:US
Practice Address - Phone:765-446-6535
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-14
Last Update Date:2012-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28047157A364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult