Provider Demographics
NPI:1093850513
Name:PARKER, CYNTHIA G (CRNA)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:G
Last Name:PARKER
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1122 COMANCHE TRL
Mailing Address - Street 2:
Mailing Address - City:WEST MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71291-8126
Mailing Address - Country:US
Mailing Address - Phone:318-699-0552
Mailing Address - Fax:
Practice Address - Street 1:1804 N 7TH ST
Practice Address - Street 2:
Practice Address - City:WEST MONROE
Practice Address - State:LA
Practice Address - Zip Code:71291-4414
Practice Address - Country:US
Practice Address - Phone:318-325-2610
Practice Address - Fax:318-325-7715
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN072171-AP03403367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1569500Medicaid
LA4B446Medicare ID - Type Unspecified