MEDICARE: TREY PARKER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	209525	LA

General Provider Information

NPI Number	:	1033096706
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TREY PARKER

Provider Business Mailing Address
First Line	:	5959 S SHERWOOD FOREST BLVD
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70816-6038
Country	:	US
Telephone Number	:	225-765-8829
Fax Number	:	225-765-9196

Provider Business Practice Location Address
First Line	:	5228 DIJON DR
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70808-4311
Country	:	US
Telephone Number	:	225-765-8829
Fax Number	:	225-765-6916

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/16/2025
Last Update Date	:	01/23/2026

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Directions to “ TREY PARKER ” Practice Location

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