Provider Demographics
NPI:1700435955
Name:PARLETTE, KRISTA KAY
Entity Type:Individual
Prefix:
First Name:KRISTA
Middle Name:KAY
Last Name:PARLETTE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 IRONWOOD LOOP
Mailing Address - Street 2:
Mailing Address - City:CRESWELL
Mailing Address - State:OR
Mailing Address - Zip Code:97426-9201
Mailing Address - Country:US
Mailing Address - Phone:541-968-7670
Mailing Address - Fax:
Practice Address - Street 1:350 IRONWOOD LOOP
Practice Address - Street 2:
Practice Address - City:CRESWELL
Practice Address - State:OR
Practice Address - Zip Code:97426-9201
Practice Address - Country:US
Practice Address - Phone:541-968-7670
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-10
Last Update Date:2019-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider