Healthcare Provider Details

I. General information

NPI: 1114996956
Provider Name (Legal Business Name): KARLA PARKES A.R.N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/15/2006
Last Update Date: 04/26/2024
Certification Date: 04/18/2024
Deactivation Date: 12/31/2020
Reactivation Date: 01/25/2021

III. Provider practice location address

12272 106TH ST NE
WALHALLA ND
58282-9519
US

IV. Provider business mailing address

1218 DELANO AVE
WALHALLA ND
58282-9519
US

V. Phone/Fax

Practice location:
  • Phone: 701-521-5122
  • Fax:
Mailing address:
  • Phone: 701-549-2888
  • Fax: 701-549-2828

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR50987
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: