Basic Information
| Provider Information | |||||||||
| NPI: | 1003296054 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PARRISH | ||||||||
| FirstName: | MARY | ||||||||
| MiddleName: | LAUREN CHEEK | ||||||||
| NamePrefix: | |||||||||
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| Credential: | AGPCNP-C | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | CHEEK | ||||||||
| OtherFirstName: | MARY | ||||||||
| OtherMiddleName: | LAUREN | ||||||||
| OtherNamePrefix: | |||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | RN | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 3001 ACADEMY RD | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | DURHAM | ||||||||
| State: | NC | ||||||||
| PostalCode: | 277072660 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9194038600 | ||||||||
| FaxNumber: | 9194898585 | ||||||||
| Practice Location | |||||||||
| Address1: | 3001 ACADEMY RD | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | DURHAM | ||||||||
| State: | NC | ||||||||
| PostalCode: | 277072660 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9194038600 | ||||||||
| FaxNumber: | 9194898585 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/04/2015 | ||||||||
| LastUpdateDate: | 06/12/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 229124 | NC | N | Nursing Service Providers | Registered Nurse | 363L00000X | 5007672 | NC | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.