Healthcare Provider Details

I. General information

NPI: 1245135441
Provider Name (Legal Business Name): DONEKA KEYAIRA PARKER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/09/2026
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5905 CLERMONT HWY
CLERMONT GA
30527-2012
US

IV. Provider business mailing address

112 COURTLAND ST NE # 1406-C
ATLANTA GA
30303-2423
US

V. Phone/Fax

Practice location:
  • Phone: 706-973-0051
  • Fax:
Mailing address:
  • Phone: 706-973-0051
  • Fax: 770-561-4698

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number0213202
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: