Provider Demographics
NPI:1720413313
Name:PARRIS, GISSELLE TRISANTI (LPN)
Entity type:Individual
Prefix:MRS
First Name:GISSELLE
Middle Name:TRISANTI
Last Name:PARRIS
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 1:29 DAVENPORT AVE
Mailing Address - Street 2:
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10805-3447
Mailing Address - Country:US
Mailing Address - Phone:347-630-6823
Mailing Address - Fax:
Practice Address - Street 1:29 DAVENPORT AVE
Practice Address - Street 2:
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10805-3447
Practice Address - Country:US
Practice Address - Phone:347-630-6823
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-13
Last Update Date:2024-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY316167164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse