Provider Demographics
NPI:1356672687
Name:PARKS, MEGAN LYNN (PA)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:LYNN
Last Name:PARKS
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
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Mailing Address - Street 1:509 N ELAM AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27403-1157
Mailing Address - Country:US
Mailing Address - Phone:336-274-1114
Mailing Address - Fax:336-274-9638
Practice Address - Street 1:509 N ELAM AVE FL 2
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27403-1157
Practice Address - Country:US
Practice Address - Phone:336-274-1114
Practice Address - Fax:336-274-9638
Is Sole Proprietor?:No
Enumeration Date:2010-01-27
Last Update Date:2019-08-21
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Provider Licenses
StateLicense IDTaxonomies
FLPA 9105362363A00000X
NC0010-09209363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant