Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | 11915 | TN |
Y | 363LG0600X | Nurse Practitioner - Gerontology | 11915 | TN |
NPI | 1063480325 |
---|---|
Provider Name | Abigail Luck Parish |
First Address | Nashville, TN 37240-0001 |
Second Address | Nashville, TN 37204-2490 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/03/2006 |
Last Update Date | 15/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
11915 | APRN LICENSE (01) | TN |
ML1375244 | DEA (01) | TN |