Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | COA.11606-NP | OH |
NPI | 1003129065 |
---|---|
Provider Name | Jennifer Lynn Parry |
First Address | Hudson, OH 44236-2683 |
Second Address | Cleveland, OH 44106-1716 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2010 |
Last Update Date | 11/10/2011 |