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General NPI Number Information
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NPI Number | 1144775719
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Entity Type | Individual
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Provider Name | KIZZY MYISHA PARKER PMHNP-BC, FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 08/24/2016
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Last Update Date | 12/02/2025
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Provider Practice Location Address
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Address Line | 785 ORCHARD DR STE 250
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City | FOLSOM
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State | CA
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Zip | 95630-5547
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Country | US
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Telephone | 916-258-2199
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Fax |
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Provider Business Mailing Address
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Address Line | 5517 CABRILLO WAY
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City | ROCKLIN
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State | CA
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Zip | 95765-5148
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Country | US
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Telephone |
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Fax |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP133624
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 163WE0003X
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Taxonomy Name | Emergency Registered Nurse
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License Number | 849560
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 95006709
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License Number State | CA
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