Provider Demographics
NPI:1497796163
Name:PARRISH, KATRINA MILLER (MD)
Entity type:Individual
Prefix:DR
First Name:KATRINA
Middle Name:MILLER
Last Name:PARRISH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KATRINA
Other - Middle Name:DEMARIS
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:4621 MORRISON DR
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36609-3353
Mailing Address - Country:US
Mailing Address - Phone:251-345-0000
Mailing Address - Fax:
Practice Address - Street 1:801 S CHEVY CHASE DR
Practice Address - Street 2:SUITE 201
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91205-4431
Practice Address - Country:US
Practice Address - Phone:818-500-5586
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-10
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA73874207Q00000X
IL0710512083C0008X
VA0101280224207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No2083C0008XAllopathic & Osteopathic PhysiciansPreventive MedicineClinical Informatics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A738740Medicaid
CAI64467Medicare UPIN