Provider Demographics
NPI:1235766205
Name:SIMONE PARKS, JANET (CNM)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:
Last Name:SIMONE PARKS
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1162 HOUSTON MILL RD NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30329-3833
Mailing Address - Country:US
Mailing Address - Phone:860-929-1382
Mailing Address - Fax:
Practice Address - Street 1:340 BOULEVARD NE STE 103
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30312-1278
Practice Address - Country:US
Practice Address - Phone:404-622-9810
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-26
Last Update Date:2020-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife