Provider Demographics
NPI:1861186389
Name:PARRISH, MARISSA L (APRN)
Entity type:Individual
Prefix:
First Name:MARISSA
Middle Name:L
Last Name:PARRISH
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:MARISSA
Other - Middle Name:L
Other - Last Name:HODGSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:3001 EXECUTIVE DR STE 130
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33762-5323
Mailing Address - Country:US
Mailing Address - Phone:727-347-0005
Mailing Address - Fax:727-541-6558
Practice Address - Street 1:508 JEFFORDS ST STE D
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756-3839
Practice Address - Country:US
Practice Address - Phone:727-443-7700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-07
Last Update Date:2024-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11026778363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology