Healthcare Provider Details

I. General information

NPI: 1407820020
Provider Name (Legal Business Name): MINCHA G PARKER APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/13/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 ROSE ST FL 2
LEXINGTON KY
40536-9464
US

IV. Provider business mailing address

800 ROSE STREET 2ND FLOOR WHITNEY-HENDRICKSON BLDG
LEXINGTON KY
40536-0098
US

V. Phone/Fax

Practice location:
  • Phone: 859-323-2222
  • Fax: 859-323-6840
Mailing address:
  • Phone: 859-323-2222
  • Fax: 859-323-6840

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number1062114
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number3002995
License Number StateKY
# 3
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number3002995
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: