Healthcare Provider Details

I. General information

NPI: 1932027000
Provider Name (Legal Business Name): MARY KAEGAN PARKS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1218 HENDERSONVILLE RD
ASHEVILLE NC
28803-1903
US

IV. Provider business mailing address

900 E SLIGH AVE UNIT 304
TAMPA FL
33604-4984
US

V. Phone/Fax

Practice location:
  • Phone: 828-277-7000
  • Fax:
Mailing address:
  • Phone: 828-708-3806
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: