Provider Demographics
NPI:1306115985
Name:PARRIES, STACEY CHERIE (LPN)
Entity type:Individual
Prefix:
First Name:STACEY
Middle Name:CHERIE
Last Name:PARRIES
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3506 RAYMONT BLVD
Mailing Address - Street 2:
Mailing Address - City:UNIVERSITY HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44118-2604
Mailing Address - Country:US
Mailing Address - Phone:216-624-7672
Mailing Address - Fax:
Practice Address - Street 1:3506 RAYMONT BLVD
Practice Address - Street 2:
Practice Address - City:UNIVERSITY HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44118-2604
Practice Address - Country:US
Practice Address - Phone:216-624-7672
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-28
Last Update Date:2011-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN.138573-M-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse