Individual
JILL MALYNN PARSONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, WHCNP
Contact information
Practice address
610 SUNSET DR, LA GRANDE, OR 97850-1248
(541) 663-3175
(541) 975-5112
Mailing address
610 SUNSET DR, LA GRANDE, OR 97850-1248
(541) 663-3175
(541) 975-5112
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
086000115RN RN
OR
363LW0102X
Women's Health Nurse Practitioner
Primary
086000115N7 WHCNP-PP
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
079178000
BLUE CROSS
OR
05
—
275432
—
OR
01
—
9305053253024
EMPLOYER ID
OR
Enumeration date
06/24/2006
Last updated
06/29/2010
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