Provider Demographics
NPI:1073577227
Name:PARKER, KATHRYN (RN, CNP)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:
Last Name:PARKER
Suffix:
Gender:F
Credentials:RN, CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 WHITE POND DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44320-1127
Mailing Address - Country:US
Mailing Address - Phone:330-572-1011
Mailing Address - Fax:330-572-1018
Practice Address - Street 1:6847 N CHESTNUT ST
Practice Address - Street 2:SUITE 330
Practice Address - City:RAVENNA
Practice Address - State:OH
Practice Address - Zip Code:44266-3929
Practice Address - Country:US
Practice Address - Phone:330-296-8048
Practice Address - Fax:330-296-8208
Is Sole Proprietor?:No
Enumeration Date:2006-04-14
Last Update Date:2010-06-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OHNP-00608363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2193899Medicaid
OH2193899Medicaid
OHS97159Medicare UPIN
NP04881Medicare PIN