Provider Demographics
NPI:1699331512
Name:PARCHMENT, TANISHA ALICIAN (LPN)
Entity type:Individual
Prefix:
First Name:TANISHA
Middle Name:ALICIAN
Last Name:PARCHMENT
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MS
Other - First Name:TANISHA
Other - Middle Name:ALICIAN
Other - Last Name:DOWDELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:141 MONTEREY BAY DR
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33426-8438
Mailing Address - Country:US
Mailing Address - Phone:561-810-7608
Mailing Address - Fax:
Practice Address - Street 1:141 MONTEREY BAY DR
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33426-8438
Practice Address - Country:US
Practice Address - Phone:561-810-7608
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-15
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPN5185219164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse