Healthcare Provider Details

I. General information

NPI: 1689889404
Provider Name (Legal Business Name): BARBARA PARKINSON RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/14/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 HARRY S TRUMAN PKWY STE 200 AA CO DEPT OF HEALTH REACH PROGRAM
ANNAPOLIS MD
21401-7042
US

IV. Provider business mailing address

4714 WASHINGTON AVE
SHADY SIDE MD
20764-9604
US

V. Phone/Fax

Practice location:
  • Phone: 410-222-4176
  • Fax:
Mailing address:
  • Phone: 410-222-4176
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License NumberR090493
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: