Provider Demographics
NPI:1063644433
Name:PARKS, AMY SCHULINGKAMP (FNP)
Entity Type:Individual
Prefix:MS
First Name:AMY
Middle Name:SCHULINGKAMP
Last Name:PARKS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:MARIE
Other - Last Name:SCHULINGKAMP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:14219 COOK RD
Mailing Address - Street 2:
Mailing Address - City:BILOXI
Mailing Address - State:MS
Mailing Address - Zip Code:39532-9719
Mailing Address - Country:US
Mailing Address - Phone:228-207-0810
Mailing Address - Fax:228-333-0440
Practice Address - Street 1:14219 COOK RD
Practice Address - Street 2:
Practice Address - City:BILOXI
Practice Address - State:MS
Practice Address - Zip Code:39532-9719
Practice Address - Country:US
Practice Address - Phone:228-207-0810
Practice Address - Fax:228-333-0440
Is Sole Proprietor?:No
Enumeration Date:2009-08-18
Last Update Date:2021-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS904050363L00000X
LA2190363LF0000X
AL1-151585363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA3B267DB49Medicare PIN