Basic Information
| Provider Information | |||||||||
| NPI: | 1891776738 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PARSLEY | ||||||||
| FirstName: | HEATHER | ||||||||
| MiddleName: | WYATT | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | APRN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4863B SCOTTSVILLE RD | ||||||||
| Address2: | |||||||||
| City: | BOWLING GREEN | ||||||||
| State: | KY | ||||||||
| PostalCode: | 421047909 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2708435662 | ||||||||
| FaxNumber: | 2708435614 | ||||||||
| Practice Location | |||||||||
| Address1: | 225 NATCHEZ TRACE AVE | ||||||||
| Address2: | |||||||||
| City: | BOWLING GREEN | ||||||||
| State: | KY | ||||||||
| PostalCode: | 421037995 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2707833573 | ||||||||
| FaxNumber: | 2707834081 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/08/2005 | ||||||||
| LastUpdateDate: | 01/14/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/14/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 1094208 | KY | N | Nursing Service Providers | Registered Nurse | 363LF0000X | 3004376 | KY | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
ID Information
| ID | Type | State | Issuer | Description | 7100020470 | 05 | KY | MEDICAID |