Provider Demographics
NPI:1083730378
Name:PARKER, NINA M (CA)
Entity Type:Individual
Prefix:
First Name:NINA
Middle Name:M
Last Name:PARKER
Suffix:
Gender:F
Credentials:CA
Other - Prefix:
Other - First Name:SAM
Other - Middle Name:
Other - Last Name:PARKER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CA
Mailing Address - Street 1:12540 ESTUARY CIR
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99516-7315
Mailing Address - Country:US
Mailing Address - Phone:907-243-0549
Mailing Address - Fax:
Practice Address - Street 1:12540 ESTUARY CIR
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99516-7315
Practice Address - Country:US
Practice Address - Phone:907-243-0549
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor