Healthcare Provider Details

I. General information

NPI: 1881862464
Provider Name (Legal Business Name): TERRI L PARKER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/15/2008
Last Update Date: 02/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6051 FRANKFORT HWY STE 200
BENZONIA MI
49616-9651
US

IV. Provider business mailing address

1516 WHITE OAK LN
INTERLOCHEN MI
49643-9465
US

V. Phone/Fax

Practice location:
  • Phone: 877-398-2013
  • Fax: 231-882-2360
Mailing address:
  • Phone: 231-276-9363
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number4704179343
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: