MEDICARE: MR. SCOTT PARKER APRN FNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	2161704405	UT

General Provider Information

NPI Number	:	1386626018
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. SCOTT PARKER APRN FNP

Provider Business Mailing Address
First Line	:	440 N PAIUTE DR
Second Line	:
City	:	CEDAR CITY
State	:	UT
Zip	:	84720-2681
Country	:	US
Telephone Number	:	485-867-1520
Fax Number	:	435-867-2658

Provider Business Practice Location Address
First Line	:	440 N PAIUTE DR
Second Line	:
City	:	CEDAR CITY
State	:	UT
Zip	:	84720-2681
Country	:	US
Telephone Number	:	485-867-1520
Fax Number	:	435-867-2658

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/17/2005
Last Update Date	:	07/08/2007

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