Healthcare Provider Details

I. General information

NPI: 1952117681
Provider Name (Legal Business Name): NANCY PARKER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/07/2024
Last Update Date: 12/07/2024
Certification Date: 12/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2601 SPENCER RD
SPENCER OK
73084-3649
US

IV. Provider business mailing address

2400 WATERMARK BLVD APT 1321
OKLAHOMA CITY OK
73134-5609
US

V. Phone/Fax

Practice location:
  • Phone: 405-427-2441
  • Fax:
Mailing address:
  • Phone: 469-268-2227
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number984213
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: