Healthcare Provider Details

I. General information

NPI: 1164370268
Provider Name (Legal Business Name): MRS. AMY LIANN MITCHELL-PARKER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/17/2026
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

131C E COLLEGE AVE
SHELBY NC
28152-9543
US

IV. Provider business mailing address

446 GANTTS GROVE CHURCH RD
MOORESBORO NC
28114-9612
US

V. Phone/Fax

Practice location:
  • Phone: 704-418-1002
  • Fax:
Mailing address:
  • Phone: 704-418-1002
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: