1932800745 NPI number — CORNERSTONE EAR NOSE & THROAT PA

Table of content: KELLY MICHELLE PARSONS ARNP (NPI 1003826991)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932800745 NPI number — CORNERSTONE EAR NOSE & THROAT PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CORNERSTONE EAR NOSE & THROAT PA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1932800745
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/17/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1107 REYNOLDS ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MONROE
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28112-4351
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
704-752-7575
Provider Business Mailing Address Fax Number:
704-752-7576

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7666 CHARLOTTE HWY STE 220
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
INDIAN LAND
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29707-0004
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
704-752-7575
Provider Business Practice Location Address Fax Number:
704-752-7576
Provider Enumeration Date:
03/17/2023

Additional Information

Authorized Official

Authorized Official Last Name:
HELMS
Authorized Official First Name:
TERESA
Authorized Official Middle Name:
M
Authorized Official Title or Position:
ADMINISTRATOR
Authorized Official Telephone Number:
704-752-7575

Provider Taxonomy Codes

  • Taxonomy code: 207Y00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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