MEDICARE: MS. SANDRA PARKER RNNPC CRNP RNAPNC

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	363L00000X	Nurse Practitioner	VP003411F	PA
2	363L00000X	Nurse Practitioner	26NN03287900	NJ

General Provider Information

NPI Number	:	1508806159
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SANDRA PARKER RNNPC CRNP RNAPNC

Provider Business Mailing Address
First Line	:	216 HALE STREET
Second Line	:
City	:	PENNINGTON
State	:	NJ
Zip	:	08534-2703
Country	:	US
Telephone Number	:	609-737-2665
Fax Number	:

Provider Business Practice Location Address
First Line	:	123 FRANKLIN CORNER RD
Second Line	:	STE 214 LAWRENCE OBGYN ASSOCIATES
City	:	LAWRENCEVILLE
State	:	NJ
Zip	:	08648-2526
Country	:	US
Telephone Number	:	609-896-1400
Fax Number	:	609-896-3986

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

Provider Enumeration Date	:	06/08/2006
Last Update Date	:	07/08/2007

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