Individual
SHANE D PARISH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSN, APRN. AGNP-C
Contact information
Practice address
1585 WOODLAKE DR STE 111, CHESTERFIELD, MO 63017-5740
(314) 645-6840
(314) 628-1046
Mailing address
1585 WOODLAKE DR STE 111, CHESTERFIELD, MO 63017-5740
(314) 645-6840
(314) 628-1046
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
2017038120
MO
Other
Enumeration date
10/30/2017
Last updated
10/30/2017
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