Provider Demographics
NPI:1386478113
Name:PARSONS, LISA (REGISTERED NURSE)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:PARSONS
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4477 ROAD 17 W
Mailing Address - Street 2:
Mailing Address - City:BUSHNELL
Mailing Address - State:NE
Mailing Address - Zip Code:69128-2803
Mailing Address - Country:US
Mailing Address - Phone:308-235-5260
Mailing Address - Fax:
Practice Address - Street 1:2360 E PERSHING BLVD
Practice Address - Street 2:
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82001-5356
Practice Address - Country:US
Practice Address - Phone:307-778-7550
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-26
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE62646163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse