Provider Demographics
NPI:1386419489
Name:PARISH, KIMBERLY S
Entity type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:S
Last Name:PARISH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1112 COURT ST
Mailing Address - Street 2:
Mailing Address - City:CHEBOYGAN
Mailing Address - State:MI
Mailing Address - Zip Code:49721-1406
Mailing Address - Country:US
Mailing Address - Phone:231-818-2516
Mailing Address - Fax:231-268-3477
Practice Address - Street 1:1112 COURT ST
Practice Address - Street 2:
Practice Address - City:CHEBOYGAN
Practice Address - State:MI
Practice Address - Zip Code:49721-1406
Practice Address - Country:US
Practice Address - Phone:231-818-2516
Practice Address - Fax:231-268-3477
Is Sole Proprietor?:No
Enumeration Date:2023-11-17
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman