Provider Demographics
NPI:1114682614
Name:PARKER, ASHLEY DARSHA BERNIC
Entity Type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:DARSHA BERNIC
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 1:110 BLOSSOM BRANCH EXT
Mailing Address - Street 2:
Mailing Address - City:PIEDMONT
Mailing Address - State:SC
Mailing Address - Zip Code:29673-8936
Mailing Address - Country:US
Mailing Address - Phone:864-735-5193
Mailing Address - Fax:
Practice Address - Street 1:151 E WOOD ST
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29303-3016
Practice Address - Country:US
Practice Address - Phone:864-735-5193
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-01
Last Update Date:2021-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC246862163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC246862Other246862