Healthcare Provider Details

I. General information

NPI: 1215496310
Provider Name (Legal Business Name): ALECIA PARKS CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/18/2019
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1480 PEARL RD STE 7
BRUNSWICK OH
44212-3457
US

IV. Provider business mailing address

7881 NEIL DR
PARMA OH
44130-7156
US

V. Phone/Fax

Practice location:
  • Phone: 440-821-6026
  • Fax:
Mailing address:
  • Phone: 234-546-1110
  • Fax: 877-683-6121

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberCNP211274
License Number StateME
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.024395
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: