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General NPI Number Information
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NPI Number | 1114440484
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Entity Type | Individual
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Provider Name | JUANITA PARKER NURSE PRACTITIONER
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Gender | Female
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Dates
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Enumeration Date | 07/19/2017
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Last Update Date | 12/18/2025
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Provider Practice Location Address
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Address Line | 1021 EDEN WAY N
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City | CHESAPEAKE
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State | VA
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Zip | 23320-2776
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Country | US
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Telephone | 757-842-4233
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Fax |
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Provider Business Mailing Address
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Address Line | 904 RILEY DR
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City | CHESAPEAKE
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State | VA
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Zip | 23322-7420
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Country | US
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Telephone | 757-546-4494
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Fax | 757-590-4159
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 0024175132
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License Number State | VA
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