Provider Demographics
NPI:1023371929
Name:PARKER, TISH ANN MARIE (FNP-C)
Entity Type:Individual
Prefix:
First Name:TISH
Middle Name:ANN MARIE
Last Name:PARKER
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:TISH
Other - Middle Name:ANN MARIE
Other - Last Name:GULDBORG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:602 HENRY CHAPPLE ST
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59106-1874
Mailing Address - Country:US
Mailing Address - Phone:406-901-2300
Mailing Address - Fax:
Practice Address - Street 1:602 HENRY CHAPPLE ST
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59106-1874
Practice Address - Country:US
Practice Address - Phone:406-901-2300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-17
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT24873363LF0000X
MT100354363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily