Healthcare Provider Details
I. General information
NPI: 1659465201
Provider Name (Legal Business Name): AMY N. PARKER RDMS, RVT, RDCS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 10/03/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
65 MAIN ST
RIENZI MS
38865
US
IV. Provider business mailing address
PO BOX 2
RIENZI MS
38865
US
V. Phone/Fax
- Phone: 662-462-5919
- Fax:
- Phone: 662-462-5919
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 246XS1301X |
| Taxonomy | Sonography Specialist/Technologist Cardiovascular |
| License Number | MRT1561 |
| License Number State | MS |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 247100000X |
| Taxonomy | Radiologic Technologist |
| License Number | MRT1561 |
| License Number State | MS |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2471S1302X |
| Taxonomy | Sonography Radiologic Technologist |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2471V0105X |
| Taxonomy | Vascular Sonography Radiologic Technologist |
| License Number | MRT1561 |
| License Number State | MS |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: