Provider Demographics
NPI:1033980453
Name:PARKER, TRACI D (CPT)
Entity Type:Individual
Prefix:MS
First Name:TRACI
Middle Name:D
Last Name:PARKER
Suffix:
Gender:F
Credentials:CPT
Other - Prefix:MRS
Other - First Name:TRACI
Other - Middle Name:D
Other - Last Name:BEDFORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CPT
Mailing Address - Street 1:151 BARRINGTON DR
Mailing Address - Street 2:
Mailing Address - City:PALM COAST
Mailing Address - State:FL
Mailing Address - Zip Code:32137-8870
Mailing Address - Country:US
Mailing Address - Phone:567-420-5398
Mailing Address - Fax:
Practice Address - Street 1:151 BARRINGTON DR
Practice Address - Street 2:
Practice Address - City:PALM COAST
Practice Address - State:FL
Practice Address - Zip Code:32137-8870
Practice Address - Country:US
Practice Address - Phone:156-742-0539
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-15
Last Update Date:2024-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy