Provider Demographics
NPI:1811344963
Name:PARSONS, MARY
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:
Last Name:PARSONS
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 1:11126 E PARKS RD
Mailing Address - Street 2:
Mailing Address - City:WHEELER
Mailing Address - State:MI
Mailing Address - Zip Code:48662-9789
Mailing Address - Country:US
Mailing Address - Phone:989-708-8711
Mailing Address - Fax:
Practice Address - Street 1:11126 E PARKS RD
Practice Address - Street 2:
Practice Address - City:WHEELER
Practice Address - State:MI
Practice Address - Zip Code:48662-9789
Practice Address - Country:US
Practice Address - Phone:989-708-8711
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-18
Last Update Date:2016-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIAF290311056163W00000X
374U00000X, 376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No163W00000XNursing Service ProvidersRegistered Nurse
No376K00000XNursing Service Related ProvidersNurse's Aide