Provider Demographics
NPI:1043414733
Name:PARKER, CYNTHIA E (NP)
Entity Type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:E
Last Name:PARKER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:DR
Other - First Name:CYNTHIA
Other - Middle Name:E
Other - Last Name:PARKER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PSYD
Mailing Address - Street 1:PO BOX 4660
Mailing Address - Street 2:23 UNCLE SAM LODE ROAD
Mailing Address - City:BRECKENRIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80424-4660
Mailing Address - Country:US
Mailing Address - Phone:970-393-2526
Mailing Address - Fax:
Practice Address - Street 1:101 WEST MAIN ST
Practice Address - Street 2:SUITE 101A
Practice Address - City:FRISCO
Practice Address - State:CO
Practice Address - Zip Code:80443
Practice Address - Country:US
Practice Address - Phone:970-393-2526
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-14
Last Update Date:2013-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3181103T00000X
CORN0176659363LG0600X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology