Provider Demographics
NPI:1073718847
Name:PARKER-PHILLIPS, KAY (MSN, CRNP)
Entity Type:Individual
Prefix:MS
First Name:KAY
Middle Name:
Last Name:PARKER-PHILLIPS
Suffix:
Gender:F
Credentials:MSN, CRNP
Other - Prefix:MS
Other - First Name:KAY
Other - Middle Name:
Other - Last Name:PARKER-PHILLIPS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSN, CRNP
Mailing Address - Street 1:1 INDEPENDENCE PLZ
Mailing Address - Street 2:SUITE 900
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35209-2629
Mailing Address - Country:US
Mailing Address - Phone:205-271-8000
Mailing Address - Fax:205-271-8022
Practice Address - Street 1:1 INDEPENDENCE PLZ
Practice Address - Street 2:SUITE 900
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209-2629
Practice Address - Country:US
Practice Address - Phone:205-271-8000
Practice Address - Fax:205-271-8022
Is Sole Proprietor?:No
Enumeration Date:2007-06-20
Last Update Date:2010-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-048723363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALGROUP # P00617303OtherRAILROAD MEDICARE PART B
AL104170Medicaid
AL515-46309OtherBLUE CROSS AND BLUE SHIELD OF ALABAMA UNIQUE PROVIDER ID NUMBER (UPIN)
510I500083OtherMEDICARE PROVIDER TRANSACTION ACCESS NUMBER (PTAN)