MEDICARE: COURTNEY L PARKER NP

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	10013293	OR
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	73849	ID
3	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	AP61350441	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	AP61350441	OTHER	WA	WA APRN
2	73849	OTHER	ID	ID APRN

General Provider Information

NPI Number	:	1972258671
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	COURTNEY L PARKER NP

Provider Business Mailing Address
First Line	:	206 W IRONWOOD DR # 1030
Second Line	:
City	:	COEUR D ALENE
State	:	ID
Zip	:	83814-2640
Country	:	US
Telephone Number	:	509-361-5154
Fax Number	:

Provider Business Practice Location Address
First Line	:	2851 N WHITE PINES DR
Second Line	:
City	:	COEUR D ALENE
State	:	ID
Zip	:	83815-6259
Country	:	US
Telephone Number	:	702-443-2442
Fax Number	:

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

Provider Enumeration Date	:	02/21/2022
Last Update Date	:	08/12/2023

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Directions to “ COURTNEY L PARKER NP” Practice Location

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