Provider Demographics
NPI:1831661651
Name:PARSONS, JENNIFER M (NP)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:M
Last Name:PARSONS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3050 FIFTH AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:KETCHIKAN
Mailing Address - State:AK
Mailing Address - Zip Code:99901-5773
Mailing Address - Country:US
Mailing Address - Phone:907-228-2410
Mailing Address - Fax:907-228-2410
Practice Address - Street 1:3050 FIFTH AVE STE 100
Practice Address - Street 2:
Practice Address - City:KETCHIKAN
Practice Address - State:AK
Practice Address - Zip Code:99901-5773
Practice Address - Country:US
Practice Address - Phone:907-228-2410
Practice Address - Fax:907-228-2411
Is Sole Proprietor?:No
Enumeration Date:2018-12-18
Last Update Date:2025-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP61412278363LF0000X
AK2321295363LF0000X
WARN60725952163W00000X
ID75868363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK1749060Medicaid
WA2077844Medicaid