1003296054 NPI number — MARY LAUREN CHEEK PARRISH AGPCNP-C

Table of content: MARY LAUREN CHEEK PARRISH AGPCNP-C (NPI 1003296054)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1003296054 NPI number — MARY LAUREN CHEEK PARRISH AGPCNP-C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PARRISH
Provider First Name:
MARY
Provider Middle Name:
LAUREN CHEEK
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
AGPCNP-C
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CHEEK
Provider Other First Name:
MARY
Provider Other Middle Name:
LAUREN
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
RN
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1003296054
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/12/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3001 ACADEMY RD
Provider Second Line Business Mailing Address:
SUITE 200
Provider Business Mailing Address City Name:
DURHAM
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27707-2660
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
919-403-8600
Provider Business Mailing Address Fax Number:
919-489-8585

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3001 ACADEMY RD
Provider Second Line Business Practice Location Address:
SUITE 200
Provider Business Practice Location Address City Name:
DURHAM
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27707-2660
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
919-403-8600
Provider Business Practice Location Address Fax Number:
919-489-8585
Provider Enumeration Date:
06/04/2015

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: 163W00000X , with the licence number:  229124 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363L00000X , with the licence number: 5007672 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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