Healthcare Provider Details

I. General information

NPI: 1699495952
Provider Name (Legal Business Name): LYNNETTE CHRISTINE PARKER FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/29/2022
Last Update Date: 11/17/2022
Certification Date: 11/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2900 WATKINS RD
BATTLE CREEK MI
49015-8604
US

IV. Provider business mailing address

601 JOHN STREET BOX 42
KALAMAZOO MI
49007
US

V. Phone/Fax

Practice location:
  • Phone: 269-245-5430
  • Fax: 269-245-5431
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4704209396
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: