Healthcare Provider Details

I. General information

NPI: 1831488543
Provider Name (Legal Business Name): CAROL ANN PARKER CNP, MSN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/04/2011
Last Update Date: 03/15/2023
Certification Date: 03/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8044 MONTGOMERY RD STE 700-7359
CINCINNATI OH
45236-2919
US

IV. Provider business mailing address

2850 PARKWALK DR
CINCINNATI OH
45239-1901
US

V. Phone/Fax

Practice location:
  • Phone: 513-372-5071
  • Fax: 513-672-2544
Mailing address:
  • Phone: 513-226-2055
  • Fax: 513-681-7933

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberCOA.15470-NP
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number272194
License Number StateAZ
# 3
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number15470-NP
License Number StateOH
# 4
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAP61254943
License Number StateWA
# 5
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License NumberMP7393426
License Number StateWA
# 6
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License NumberMP3180724
License Number StateOH
# 7
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN316056
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: