Provider Demographics
NPI:1386626018
Name:PARKER, SCOTT (APRN FNP)
Entity Type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:
Last Name:PARKER
Suffix:
Gender:M
Credentials:APRN FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:440 N PAIUTE DR
Mailing Address - Street 2:
Mailing Address - City:CEDAR CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84720-2681
Mailing Address - Country:US
Mailing Address - Phone:485-867-1520
Mailing Address - Fax:435-867-2658
Practice Address - Street 1:440 N PAIUTE DR
Practice Address - Street 2:
Practice Address - City:CEDAR CITY
Practice Address - State:UT
Practice Address - Zip Code:84720-2681
Practice Address - Country:US
Practice Address - Phone:485-867-1520
Practice Address - Fax:435-867-2658
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT2161704405363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
P32693Medicare UPIN
UTP32693Medicare ID - Type Unspecified