Healthcare Provider Details

I. General information

NPI: 1154865566
Provider Name (Legal Business Name): MARILYN K PARKER ACNS-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/05/2016
Last Update Date: 12/05/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3901 RAINBOW BLVD
KANSAS CITY KS
66160-8500
US

IV. Provider business mailing address

918 APRIL RAIN RD
LAWRENCE KS
66049-4702
US

V. Phone/Fax

Practice location:
  • Phone: 913-588-0600
  • Fax: 913-588-8005
Mailing address:
  • Phone: 913-588-0600
  • Fax: 913-588-8005

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SA2200X
TaxonomyAdult Health Clinical Nurse Specialist
License Number74500
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: