Provider Demographics
NPI:1285488114
Name:PARVIS, SHOLLY (RN, IBCLC)
Entity type:Individual
Prefix:
First Name:SHOLLY
Middle Name:
Last Name:PARVIS
Suffix:
Gender:F
Credentials:RN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1731 MILLBROOK LN
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:45140-6014
Mailing Address - Country:US
Mailing Address - Phone:513-399-9118
Mailing Address - Fax:
Practice Address - Street 1:10979 REED HARTMAN HWY STE 239
Practice Address - Street 2:
Practice Address - City:BLUE ASH
Practice Address - State:OH
Practice Address - Zip Code:45242-2882
Practice Address - Country:US
Practice Address - Phone:513-399-9118
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-16
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.411108163WL0100X
OHL-303778163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant