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General NPI Number Information
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NPI Number | 1962190090
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Entity Type | Individual
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Provider Name | CASSANDRA SHIVAR PARKER FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 04/26/2023
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Last Update Date | 05/05/2025
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Provider Practice Location Address
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Address Line | 220 N MAIN ST STE 500
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City | GREENVILLE
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State | SC
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Zip | 29601-2129
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Country | US
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Telephone | 929-299-4428
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Fax | 929-299-4428
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Provider Business Mailing Address
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Address Line | 10 BIG OAK ST
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City | HILTON HEAD ISLAND
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State | SC
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Zip | 29926-1140
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Country | US
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Telephone | 843-460-0962
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Fax | 929-299-4428
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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 | 212045
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | RN224536
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License Number State | GA
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