Healthcare Provider Details

I. General information

NPI: 1083770820
Provider Name (Legal Business Name): LAURA PARKER RN, LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/28/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4457 MELLWOOD AVE
CINCINNATI OH
45232-1843
US

IV. Provider business mailing address

4457 MELLWOOD AVE
CINCINNATI OH
45232-1843
US

V. Phone/Fax

Practice location:
  • Phone: 513-681-4688
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License NumberRN218092
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: