Provider Demographics
NPI:1063684819
Name:PARNELL, HEATHER L (ARNP)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:L
Last Name:PARNELL
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 PARK ST
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42101-1759
Mailing Address - Country:US
Mailing Address - Phone:270-781-2111
Mailing Address - Fax:270-781-2722
Practice Address - Street 1:201 PARK ST
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42101-1759
Practice Address - Country:US
Practice Address - Phone:270-781-2111
Practice Address - Fax:270-781-2722
Is Sole Proprietor?:No
Enumeration Date:2008-04-01
Last Update Date:2018-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3005484363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYK098060Medicare PIN
KY0277509Medicare PIN
KY0277707Medicare PIN
KY0277307Medicare PIN
KY0277407Medicare PIN
KYK098062Medicare PIN
KY0277907Medicare PIN
KYK098061Medicare PIN