Basic Information
| Provider Information | |||||||||
| NPI: | 1356661722 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PARENT | ||||||||
| FirstName: | CHRISTY | ||||||||
| MiddleName: | STOCKTON | ||||||||
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| Credential: | PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 32255 NORTHWESTERN HWY | ||||||||
| Address2: | |||||||||
| City: | FARMINGTON HILLS | ||||||||
| State: | MI | ||||||||
| PostalCode: | 483341566 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8886471100 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 32255 NORTHWESTERN HWY STE 100 | ||||||||
| Address2: | |||||||||
| City: | FARMINGTON HILLS | ||||||||
| State: | MI | ||||||||
| PostalCode: | 483341573 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8886471100 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/08/2010 | ||||||||
| LastUpdateDate: | 10/12/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/12/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | 5601005755 | MI | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.