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NPI Code Detail

MEDICARE: DOROTHEA LYNN PARKER RN

MEDICARE: DOROTHEA LYNN PARKER RN
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
1163W00000XRegistered Nurse28170486AIN

General Provider Information

NPI Number : 1437763596
Entity Type Code : Individual
Provider Name (Legal Business Name) : DOROTHEA LYNN PARKER RN
Provider Business Mailing Address
First Line : 9801 SW 190TH AVENUE RD
Second Line :
City : DUNNELLON
State : FL
Zip : 34432-4224
Country : US
Telephone Number : 812-360-7765
Fax Number :
Provider Business Practice Location Address
First Line : 1601 SW ARCHER RD
Second Line :
City : GAINESVILLE
State : FL
Zip : 32608-1135
Country : US
Telephone Number : 352-376-1611
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/04/2020
Last Update Date : 09/04/2020

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