Provider Demographics
NPI:1346208329
Name:PARKER, LINDALEA E (CRNA)
Entity Type:Individual
Prefix:MRS
First Name:LINDALEA
Middle Name:E
Last Name:PARKER
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 COMMERCE DRIVE
Mailing Address - Street 2:
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10801-5214
Mailing Address - Country:US
Mailing Address - Phone:914-637-3510
Mailing Address - Fax:914-819-0061
Practice Address - Street 1:907 18TH STREET
Practice Address - Street 2:SUITE 460
Practice Address - City:TIFTON
Practice Address - State:GA
Practice Address - Zip Code:31794-3684
Practice Address - Country:US
Practice Address - Phone:229-391-3625
Practice Address - Fax:229-391-3639
Is Sole Proprietor?:No
Enumeration Date:2006-05-01
Last Update Date:2009-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN050697367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000510012BMedicaid
GAR12420Medicare UPIN
GA000510012BMedicaid