Provider Demographics
NPI:1194726182
Name:PARSONS, LAURA ANN (PA-C)
Entity type:Individual
Prefix:MS
First Name:LAURA
Middle Name:ANN
Last Name:PARSONS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2805 5TH ST
Mailing Address - Street 2:220
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57701-6003
Mailing Address - Country:US
Mailing Address - Phone:605-348-1084
Mailing Address - Fax:605-348-3256
Practice Address - Street 1:2805 5TH ST
Practice Address - Street 2:220
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57701-6003
Practice Address - Country:US
Practice Address - Phone:605-348-1084
Practice Address - Fax:605-348-3256
Is Sole Proprietor?:No
Enumeration Date:2005-08-02
Last Update Date:2007-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD0566363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD6825482Medicaid
SDQ09199Medicare UPIN
SD6825482Medicaid