1588640221 NPI number — MRS. NANCY ANN PARSONS CNP P.A.-C

Table of content: MRS. NANCY ANN PARSONS CNP P.A.-C (NPI 1588640221)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1588640221 NPI number — MRS. NANCY ANN PARSONS CNP P.A.-C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PARSONS
Provider First Name:
NANCY
Provider Middle Name:
ANN
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
CNP P.A.-C
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1588640221
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/17/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
405 W. COUNTRY CLUB RD
Provider Second Line Business Mailing Address:
C/O MSO ADMINISTRATION
Provider Business Mailing Address City Name:
ROSWELL
Provider Business Mailing Address State Name:
NM
Provider Business Mailing Address Postal Code:
88201
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
575-622-1841
Provider Business Mailing Address Fax Number:
575-622-5317

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
350 W. COUNTRY CLUB RD
Provider Second Line Business Practice Location Address:
STE. #201
Provider Business Practice Location Address City Name:
ROSWELL
Provider Business Practice Location Address State Name:
NM
Provider Business Practice Location Address Postal Code:
88201
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
575-622-1841
Provider Business Practice Location Address Fax Number:
575-622-5317
Provider Enumeration Date:
12/15/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  R10041 , registered in the state of NM ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207Q00000X , with the licence number: 92-PA17 , registered in the state of NM ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363A00000X , with the licence number: 92-PA17 , registered in the state of NM ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)