Healthcare Provider Details

I. General information

NPI: 1073606398
Provider Name (Legal Business Name): JOY CHRISTINE PARKER CPM, LM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/30/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 7TH AVE N
SAUK RAPIDS MN
56379-2026
US

IV. Provider business mailing address

120 7TH AVE N
SAUK RAPIDS MN
56379-2026
US

V. Phone/Fax

Practice location:
  • Phone: 320-202-5989
  • Fax:
Mailing address:
  • Phone: 320-202-5989
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number1011
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: