Provider Demographics
NPI:1396504643
Name:PARRIS, PAXTON ELISE (FNP-C)
Entity type:Individual
Prefix:
First Name:PAXTON
Middle Name:ELISE
Last Name:PARRIS
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17678 LORETTA DR
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEBURG
Mailing Address - State:IN
Mailing Address - Zip Code:47025-9707
Mailing Address - Country:US
Mailing Address - Phone:181-229-0904
Mailing Address - Fax:
Practice Address - Street 1:17678 LORETTA DR
Practice Address - Street 2:
Practice Address - City:LAWRENCEBURG
Practice Address - State:IN
Practice Address - Zip Code:47025-9707
Practice Address - Country:US
Practice Address - Phone:181-229-0904
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-18
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHF07230570363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily