Provider Demographics
NPI:1164540654
Name:PARKER, GLORIA D (RD, CD, CDE)
Entity Type:Individual
Prefix:MS
First Name:GLORIA
Middle Name:D
Last Name:PARKER
Suffix:
Gender:F
Credentials:RD, CD, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3049 N LAKE DR
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53211-3403
Mailing Address - Country:US
Mailing Address - Phone:414-964-7107
Mailing Address - Fax:414-964-6284
Practice Address - Street 1:COLUMBIA ST. MARY'S HOSPITAL, DIABETES TREATMENT CTR
Practice Address - Street 2:2025 E NEWPORT AVE
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53211
Practice Address - Country:US
Practice Address - Phone:414-961-4641
Practice Address - Fax:414-961-4435
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered