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NPI Code Detail

MEDICARE: MRS. MARILYNN PARKER APN, FNP-C

MEDICARE: MRS. MARILYNN PARKER APN, FNP-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
1363LF0000XFamily Nurse Practitioner209.007262IL
2363LF0000XFamily Nurse Practitioner209007262IL

General Provider Information

NPI Number : 1366670341
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MARILYNN PARKER APN, FNP-C
Provider Business Mailing Address
First Line : 1 CVS DR
Second Line :
City : WOONSOCKET
State : RI
Zip : 02895-6146
Country : US
Telephone Number : 612-225-1534
Fax Number :
Provider Business Practice Location Address
First Line : 3637 N SOUTHPORT AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60613-3709
Country : US
Telephone Number : 773-348-5282
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/29/2009
Last Update Date : 07/21/2022

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