Provider Demographics
NPI:1275961948
Name:PARKER, AMY (APN)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:PARKER
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3840 QUAKERBRIDGE RD
Mailing Address - Street 2:BUILDING 2, SUITE 110
Mailing Address - City:MERCERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08619-1003
Mailing Address - Country:US
Mailing Address - Phone:609-890-4200
Mailing Address - Fax:609-586-0399
Practice Address - Street 1:3840 QUAKERBRIDGE RD
Practice Address - Street 2:BUILDING 2, SUITE 110
Practice Address - City:MERCERVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08619-1003
Practice Address - Country:US
Practice Address - Phone:609-890-4200
Practice Address - Fax:609-586-0399
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-16
Last Update Date:2021-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00470000363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily