Provider Demographics
NPI:1588294359
Name:PARHAM, NANCY J (RN)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:J
Last Name:PARHAM
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:J
Other - Last Name:RESAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:118 N 2ND ST STE 200
Mailing Address - Street 2:
Mailing Address - City:SAINT CHARLES
Mailing Address - State:MO
Mailing Address - Zip Code:63301-2894
Mailing Address - Country:US
Mailing Address - Phone:636-224-1210
Mailing Address - Fax:636-946-0991
Practice Address - Street 1:6910 N HOLMES ST STE 231
Practice Address - Street 2:
Practice Address - City:GLADSTONE
Practice Address - State:MO
Practice Address - Zip Code:64118-2666
Practice Address - Country:US
Practice Address - Phone:816-353-2750
Practice Address - Fax:816-478-7408
Is Sole Proprietor?:No
Enumeration Date:2020-01-21
Last Update Date:2020-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1482469031163W00000X
MO095708163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse