Provider Demographics
NPI:1245348689
Name:PARISH, NANCI W (FNP-BC)
Entity type:Individual
Prefix:
First Name:NANCI
Middle Name:W
Last Name:PARISH
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5959 S SHERWOOD FOREST BLVD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-6038
Mailing Address - Country:US
Mailing Address - Phone:225-765-5727
Mailing Address - Fax:225-765-9691
Practice Address - Street 1:1702 A HWY 11 NORTH
Practice Address - Street 2:
Practice Address - City:PICAYUNE
Practice Address - State:MS
Practice Address - Zip Code:39466-0419
Practice Address - Country:US
Practice Address - Phone:601-799-3130
Practice Address - Fax:601-799-3132
Is Sole Proprietor?:No
Enumeration Date:2006-08-27
Last Update Date:2021-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR619442363LF0000X
MS619442363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS1053544155OtherGOUP: LIGHTHOUSE HEALTHCARE NANCI PARISH LLC
MS264793184OtherTAXONOMY
MS640507572VWOtherAMERICAN ADMIN GROUP
MS00117683Medicaid
LA1001384Medicaid
MS1053544155OtherGOUP: LIGHTHOUSE HEALTHCARE NANCI PARISH LLC
MS00117683Medicaid
MS302I502481Medicare PIN
MS302I501480Medicare PIN