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NPI Code Detail

MEDICARE: SCOTT DAVID PARKER FNP-BC

MEDICARE:   SCOTT DAVID PARKER  FNP-BC
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
1363LF0000XFamily Nurse PractitionerAPN.0994236-NPCO

General Provider Information

NPI Number : 1215404595
Entity Type Code : Individual
Provider Name (Legal Business Name) : SCOTT DAVID PARKER FNP-BC
Provider Business Mailing Address
First Line : 5450 WESTERN AVE
Second Line :
City : BOULDER
State : CO
Zip : 80301-2709
Country : US
Telephone Number : 303-415-5199
Fax Number : 303-415-5198
Provider Business Practice Location Address
First Line : 6685 GUNPARK DR STE 102
Second Line :
City : BOULDER
State : CO
Zip : 80301-3343
Country : US
Telephone Number : 303-415-5199
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/25/2018
Last Update Date : 02/05/2019

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Directions to “ SCOTT DAVID PARKER FNP-BC” Practice Location

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