Basic Information
| Provider Information | |||||||||
| NPI: | 1235101528 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PARRISH-LITTLEJOHN | ||||||||
| FirstName: | EDWINA | ||||||||
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| Credential: | PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1000 CARONDELET DR | ||||||||
| Address2: | PROVIDER ENROLLMENT MEDICAL STAFF OFFICE | ||||||||
| City: | KANSAS CITY | ||||||||
| State: | MO | ||||||||
| PostalCode: | 641144673 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8169437649 | ||||||||
| FaxNumber: | 8163032484 | ||||||||
| Practice Location | |||||||||
| Address1: | 930 CARONDELET DR STE 201 | ||||||||
| Address2: | |||||||||
| City: | KANSAS CITY | ||||||||
| State: | MO | ||||||||
| PostalCode: | 641144698 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8169437649 | ||||||||
| FaxNumber: | 8169432165 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/02/2006 | ||||||||
| LastUpdateDate: | 02/01/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/25/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | 2003000103 | MO | N | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | 363AS0400X | 15-00860 | KS | N | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Surgical | 363AS0400X | 2003000103 | MO | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Surgical |
No ID Information.