Provider Demographics
NPI:1255443966
Name:PARRISH, DEBRA ANNE (MD)
Entity type:Individual
Prefix:DR
First Name:DEBRA
Middle Name:ANNE
Last Name:PARRISH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1055 CENTERVILLE CIR
Mailing Address - Street 2:
Mailing Address - City:VADNAIS HEIGHTS
Mailing Address - State:MN
Mailing Address - Zip Code:55127-5033
Mailing Address - Country:US
Mailing Address - Phone:651-326-5900
Mailing Address - Fax:
Practice Address - Street 1:1055 CENTERVILLE CIR
Practice Address - Street 2:
Practice Address - City:VADNAIS HEIGHTS
Practice Address - State:MN
Practice Address - Zip Code:55127-5033
Practice Address - Country:US
Practice Address - Phone:651-326-5900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2016-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO41550207Q00000X
MN55549207Q00000X
HIMD16849207Q00000X
IDM-9727207Q00000X
WAMD00047237207Q00000X
TXN2929207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID76770OtherIDAHO BLUE CROSS
ID000010159479OtherIDAHO REGENCE BLUESHIELD
ID1134201OtherDMERC
ID807589500OtherHEALTHY CONNECTIONS
WA8466633Medicaid
WA0214762OtherWA LABOR & INDUSTRIES
ID807589500Medicaid
ID807589500Medicaid
ID807589500OtherHEALTHY CONNECTIONS
H18028Medicare UPIN
WA8466633Medicaid