Provider Demographics
NPI:1649977331
Name:PARSONS, JENNY (RN)
Entity type:Individual
Prefix:
First Name:JENNY
Middle Name:
Last Name:PARSONS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1562 MAPLE LN
Mailing Address - Street 2:
Mailing Address - City:BENTON HARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:49022-9503
Mailing Address - Country:US
Mailing Address - Phone:269-408-4363
Mailing Address - Fax:
Practice Address - Street 1:1562 MAPLE LN
Practice Address - Street 2:
Practice Address - City:BENTON HARBOR
Practice Address - State:MI
Practice Address - Zip Code:49022-9503
Practice Address - Country:US
Practice Address - Phone:269-408-4363
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-13
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704198645163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management