Provider Demographics
NPI:1669079604
Name:PARHAM, JESSICA YVONNE (REGISTERED NURSE)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:YVONNE
Last Name:PARHAM
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:779 STANLEY AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43206-2438
Mailing Address - Country:US
Mailing Address - Phone:614-822-1144
Mailing Address - Fax:
Practice Address - Street 1:2501 SPRING ST # A
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15210-2630
Practice Address - Country:US
Practice Address - Phone:937-972-1932
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-02
Last Update Date:2025-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH398311163WA0400X, 163WC0400X, 163WC1500X, 374J00000X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)
No163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No374J00000XNursing Service Related ProvidersDoula