Healthcare Provider Details

I. General information

NPI: 1376096768
Provider Name (Legal Business Name): NATALIE JEAN PARKER APRN, WHNP-BC, CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/02/2016
Last Update Date: 03/21/2024
Certification Date: 03/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555 N COURT ST
ROCKFORD IL
61103-6862
US

IV. Provider business mailing address

2209 N COURT ST
ROCKFORD IL
61103-3927
US

V. Phone/Fax

Practice location:
  • Phone: 815-720-4000
  • Fax:
Mailing address:
  • Phone: 608-609-0688
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WW0101X
TaxonomyAmbulatory Women's Health Care Registered Nurse
License Number165793-30
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number7021-33
License Number StateWI
# 3
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberCNM08060
License Number StateIL
# 4
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number209020451
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: