Provider Demographics
NPI:1073541009
Name:PARKER, VIRGINIA ANNE (MPAS, PA-C)
Entity Type:Individual
Prefix:MRS
First Name:VIRGINIA
Middle Name:ANNE
Last Name:PARKER
Suffix:
Gender:F
Credentials:MPAS, PA-C
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Mailing Address - Street 1:4714 HIGHLANDS PLACE DR
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33813-2161
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3240 S FLORIDA AVE
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33803-4574
Practice Address - Country:US
Practice Address - Phone:863-701-2470
Practice Address - Fax:863-701-2474
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2007-07-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLPA9103608363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant