Provider Demographics
NPI:1003102716
Name:PARKER, DENISA DAWN (APRN)
Entity Type:Individual
Prefix:MRS
First Name:DENISA
Middle Name:DAWN
Last Name:PARKER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MS
Other - First Name:DENISA
Other - Middle Name:DAWN
Other - Last Name:TOLLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 776351
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-6351
Mailing Address - Country:US
Mailing Address - Phone:502-588-9490
Mailing Address - Fax:502-272-5116
Practice Address - Street 1:2355 POPLAR LEVEL ROAD
Practice Address - Street 2:STE 200
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40217-1385
Practice Address - Country:US
Practice Address - Phone:502-636-7444
Practice Address - Fax:502-636-7340
Is Sole Proprietor?:No
Enumeration Date:2011-06-21
Last Update Date:2021-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3006961363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily