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General NPI Number Information
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NPI Number | 1376508218
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Entity Type | Individual
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Provider Name | SUSAN PARKER CRNP
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Gender | Female
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Dates
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Enumeration Date | 04/20/2006
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Last Update Date | 04/24/2014
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Provider Practice Location Address
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Address Line | 18324 ALABAMA HIGHWAY 75
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City | HENAGAR
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State | AL
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Zip | 35978
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Country | US
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Telephone | 256-657-1101
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Fax | 256-657-1115
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Provider Business Mailing Address
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Address Line | PO BOX 518 18324 AL HWY 75
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City | HENAGAR
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State | AL
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Zip | 35978-0518
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Country | US
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Telephone | 256-657-1101
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Fax | 256-657-1115
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 1052657
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License Number State | AL
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