Healthcare Provider Details

I. General information

NPI: 1508806159
Provider Name (Legal Business Name): SANDRA PARKER RNNPC CRNP RNAPNC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

123 FRANKLIN CORNER RD STE 214 LAWRENCE OBGYN ASSOCIATES
LAWRENCEVILLE NJ
08648-2526
US

IV. Provider business mailing address

216 HALE STREET
PENNINGTON NJ
08534-2703
US

V. Phone/Fax

Practice location:
  • Phone: 609-896-1400
  • Fax: 609-896-3986
Mailing address:
  • Phone: 609-737-2665
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberVP003411F
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number26NN03287900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: