MEDICARE: SADE PARKER

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	374U00000X	Home Health Aide
2	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1871298125
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SADE PARKER

Provider Business Mailing Address
First Line	:	40563 EMERALD LN W
Second Line	:
City	:	CLINTON TOWNSHIP
State	:	MI
Zip	:	48038-4753
Country	:	US
Telephone Number	:	586-909-3067
Fax Number	:

Provider Business Practice Location Address
First Line	:	40563 EMERALD LN W
Second Line	:
City	:	CLINTON TOWNSHIP
State	:	MI
Zip	:	48038-4753
Country	:	US
Telephone Number	:	586-909-3067
Fax Number	:

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

Provider Enumeration Date	:	04/04/2023
Last Update Date	:	04/04/2023

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Directions to “ SADE PARKER ” Practice Location

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