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General NPI Number Information
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NPI Number | 1528205119
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Entity Type | Individual
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Provider Name | ALICIA SUE PARKS PA-C
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Gender | Female
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Dates
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Enumeration Date | 01/19/2009
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 6370 W. UNION HILLS DR.
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City | GLENDALE
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State | AZ
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Zip | 85308
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Country | US
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Telephone | 623-414-3500
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Fax | 623-455-9214
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Provider Business Mailing Address
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Address Line | 6370 W. UNION HILLS DR
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City | GLENDALE
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State | AZ
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Zip | 85308
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Country | US
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Telephone | 623-414-3500
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Fax | 623-455-9214
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 4368
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 1461
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License Number State | NE
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