Provider Demographics
NPI:1861957722
Name:PARRISH, MICHAELA R (PA-C)
Entity type:Individual
Prefix:
First Name:MICHAELA
Middle Name:R
Last Name:PARRISH
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 2290
Mailing Address - Street 2:
Mailing Address - City:KEARNEY
Mailing Address - State:NE
Mailing Address - Zip Code:68848
Mailing Address - Country:US
Mailing Address - Phone:308-865-2767
Mailing Address - Fax:308-865-2765
Practice Address - Street 1:620 EAST 25TH STREET
Practice Address - Street 2:
Practice Address - City:KEARNEY
Practice Address - State:NE
Practice Address - Zip Code:68847-5511
Practice Address - Country:US
Practice Address - Phone:308-865-2767
Practice Address - Fax:308-865-2765
Is Sole Proprietor?:No
Enumeration Date:2019-02-05
Last Update Date:2025-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2319363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical