Provider Demographics
NPI:1770315392
Name:PARMER, VANASSA JEAN
Entity type:Individual
Prefix:
First Name:VANASSA
Middle Name:JEAN
Last Name:PARMER
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 1:582 MCKINLEY AVE
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:OH
Mailing Address - Zip Code:43055-6749
Mailing Address - Country:US
Mailing Address - Phone:208-513-5698
Mailing Address - Fax:
Practice Address - Street 1:582 MCKINLEY AVE
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:OH
Practice Address - Zip Code:43055-6749
Practice Address - Country:US
Practice Address - Phone:208-513-5698
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-14
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant