Healthcare Provider Details

I. General information

NPI: 1609243526
Provider Name (Legal Business Name): EVIN PARKER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2015
Last Update Date: 08/26/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 HOSPITAL RD SUITE 2A
LEOMINSTER MA
01453-2253
US

IV. Provider business mailing address

100 HOSPITAL RD SUITE 2A
LEOMINSTER MA
01453-2253
US

V. Phone/Fax

Practice location:
  • Phone: 978-466-2692
  • Fax:
Mailing address:
  • Phone: 978-466-2692
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberRN264653
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: