Healthcare Provider Details

I. General information

NPI: 1932096716
Provider Name (Legal Business Name): PARKER GORDON RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2025
Last Update Date: 06/23/2025
Certification Date: 06/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4000 CAMBRIDGE ST
KANSAS CITY KS
66160-8501
US

IV. Provider business mailing address

3205 W 72ND ST
PRAIRIE VILLAGE KS
66208-3155
US

V. Phone/Fax

Practice location:
  • Phone: 913-213-4370
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number13-160602-041
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: