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General NPI Number Information
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NPI Number | 1760467625
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Entity Type | Individual
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Provider Name | LORI ANN PARKER NP C
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Gender | Female
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Dates
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Enumeration Date | 12/13/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | SHC 100 BYU IDAHO
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City | REXBURG
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State | ID
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Zip | 83460-2010
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Country | US
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Telephone | 208-496-1300
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Fax | 208-496-1306
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Provider Business Mailing Address
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Address Line | 4218 E 400 N
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City | RIGBY
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State | ID
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Zip | 83442-5523
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Country | US
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Telephone | 208-745-5215
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | NP 660A
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License Number State | ID
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