Healthcare Provider Details

I. General information

NPI: 1740513274
Provider Name (Legal Business Name): APRIL D PARKER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2009
Last Update Date: 09/16/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

129 WALLACE RD
WADESBORO NC
28170-2434
US

IV. Provider business mailing address

6687 AVENIDA OAKLEIGH
NAVARRE FL
32566-8923
US

V. Phone/Fax

Practice location:
  • Phone: 910-322-9817
  • Fax: 850-515-0260
Mailing address:
  • Phone: 850-515-0220
  • Fax: 850-515-0260

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. APRIL DIANN PARKER
Title or Position: OWNER
Credential:
Phone: 850-515-0220