Provider Demographics
NPI:1346529252
Name:CHEN, AUDREY PARKER (RN, CPNP-PC/AC)
Entity Type:Individual
Prefix:MRS
First Name:AUDREY
Middle Name:PARKER
Last Name:CHEN
Suffix:
Gender:F
Credentials:RN, CPNP-PC/AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1246 FLOYD AVE SW
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24015-2529
Mailing Address - Country:US
Mailing Address - Phone:502-386-0483
Mailing Address - Fax:
Practice Address - Street 1:1906 BELLEVIEW AVENUE
Practice Address - Street 2:CARILION CLINIC DEPARTMENT OF EMERGENCY MEDICINE
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24014
Practice Address - Country:US
Practice Address - Phone:540-266-6331
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-09
Last Update Date:2013-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024169507363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics