Healthcare Provider Details

I. General information

NPI: 1679423420
Provider Name (Legal Business Name): MONIQUE ANGEL PARKER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/31/2026
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date: 08/22/2026
Reactivation Date: 09/02/2026

III. Provider practice location address

8815 SPRING RD
PARKVILLE MD
21234-2907
US

IV. Provider business mailing address

8815 SPRING RD
PARKVILLE MD
21234-2907
US

V. Phone/Fax

Practice location:
  • Phone: 443-474-4069
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAC009305
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: