Healthcare Provider Details

I. General information

NPI: 1306292834
Provider Name (Legal Business Name): LYNDSEY C PARKER PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LYNDSEY C PARKER PA

II. Dates (important events)

Enumeration Date: 05/13/2016
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

80 VERMONT AVE
OAK RIDGE TN
37830-6474
US

IV. Provider business mailing address

80 VERMONT AVE
OAK RIDGE TN
37830-6474
US

V. Phone/Fax

Practice location:
  • Phone: 865-482-4078
  • Fax:
Mailing address:
  • Phone: 865-482-4078
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number3011
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: