Provider Demographics
NPI:1104710664
Name:PARKER, KRISTIN JO
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:JO
Last Name:PARKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:DILLONVALE
Mailing Address - State:OH
Mailing Address - Zip Code:43917-7992
Mailing Address - Country:US
Mailing Address - Phone:740-317-4207
Mailing Address - Fax:
Practice Address - Street 1:528 SPENCE LN APT 213
Practice Address - Street 2:
Practice Address - City:MARTINS FERRY
Practice Address - State:OH
Practice Address - Zip Code:43935-1665
Practice Address - Country:US
Practice Address - Phone:740-317-1456
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-06
Last Update Date:2025-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant