MEDICARE: MRS. CECILIA MARIETTA PARKER PMHNP-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
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	R183414	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1255807160
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CECILIA MARIETTA PARKER PMHNP-BC

Provider Business Mailing Address
First Line	:	12501 TIMBER GROVE RD
Second Line	:
City	:	REISTERSTOWN
State	:	MD
Zip	:	21136-1819
Country	:	US
Telephone Number	:	667-877-5972
Fax Number	:	443-781-7692

Provider Business Practice Location Address
First Line	:	4727 OLD COURT RD
Second Line	:
City	:	PIKESVILLE
State	:	MD
Zip	:	21208-2347
Country	:	US
Telephone Number	:	667-877-5972
Fax Number	:	443-781-7692

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

Provider Enumeration Date	:	10/17/2018
Last Update Date	:	03/11/2026

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