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NPI Code Detail

MEDICARE: MR. NICHOLAS CAMPBELL PARKER PA-C

MEDICARE: MR. NICHOLAS CAMPBELL PARKER PA-C
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
1363A00000XPhysician Assistant

General Provider Information

NPI Number : 1164159893
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. NICHOLAS CAMPBELL PARKER PA-C
Provider Business Mailing Address
First Line : 29 TAYLOR AVE STE 101
Second Line :
City : CROSSVILLE
State : TN
Zip : 38555-4536
Country : US
Telephone Number : 931-484-6061
Fax Number : 931-484-6062
Provider Business Practice Location Address
First Line : 29 TAYLOR AVE STE 101
Second Line :
City : CROSSVILLE
State : TN
Zip : 38555-4536
Country : US
Telephone Number : 931-484-6061
Fax Number : 931-484-6062
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/03/2022
Last Update Date : 03/13/2023

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Directions to “ MR. NICHOLAS CAMPBELL PARKER PA-C” Practice Location

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