Provider Demographics
NPI:1255646352
Name:PARROT IMMEL, JENNIFER MARIE (MA)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:MARIE
Last Name:PARROT IMMEL
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54 SHIPWRECK CT
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31410-2112
Mailing Address - Country:US
Mailing Address - Phone:912-897-1551
Mailing Address - Fax:912-897-1551
Practice Address - Street 1:54 SHIPWRECK CT
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31410-2112
Practice Address - Country:US
Practice Address - Phone:912-897-1551
Practice Address - Fax:912-897-1551
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-12
Last Update Date:2010-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator