Provider Demographics
NPI:1831168079
Name:PARRISH, CAROLE LYNETTE (NP-C)
Entity type:Individual
Prefix:
First Name:CAROLE
Middle Name:LYNETTE
Last Name:PARRISH
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:CAROLE
Other - Middle Name:LYNETTE
Other - Last Name:ABERNATHY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 743070
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-3070
Mailing Address - Country:US
Mailing Address - Phone:864-560-4304
Mailing Address - Fax:864-560-4413
Practice Address - Street 1:1075 TOWN CENTER DR
Practice Address - Street 2:
Practice Address - City:ORANGE CITY
Practice Address - State:FL
Practice Address - Zip Code:32763-8360
Practice Address - Country:US
Practice Address - Phone:386-917-0333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-17
Last Update Date:2024-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCAPN 2663208G00000X
FL11006033363LC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LC0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCritical Care Medicine
No208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC196544OtherMEDCOST
NC0597LOtherBLUE CROSS
SCNP1048Medicaid
NC7004029Medicaid
SCAA10165019OtherMEDICARE PIN
SCNP1048Medicaid