Healthcare Provider Details

I. General information

NPI: 1639517659
Provider Name (Legal Business Name): SHEILA ANNETTE PARKER CPA, IPP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SHEILA ANNETTE TEAL CPA

II. Dates (important events)

Enumeration Date: 06/12/2013
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 LA VETA DR NE
ALBUQUERQUE NM
87108-1615
US

IV. Provider business mailing address

222 LA VETA DR NE
ALBUQUERQUE NM
87108-1615
US

V. Phone/Fax

Practice location:
  • Phone: 505-312-8815
  • Fax:
Mailing address:
  • Phone: 505-312-8815
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1744R1102X
TaxonomyResearch Study Specialist
License Number4583191
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License Number4583191
License Number StateNM
# 3
Primary TaxonomyY
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number4583191
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: