Provider Demographics
NPI:1417103953
Name:PARKER, KRISTINE I (MBBS)
Entity Type:Individual
Prefix:DR
First Name:KRISTINE
Middle Name:I
Last Name:PARKER
Suffix:
Gender:F
Credentials:MBBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:96 JONATHAN LUCAS STREET
Mailing Address - Street 2:SUITE 816
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29425-6240
Mailing Address - Country:US
Mailing Address - Phone:843-792-2529
Mailing Address - Fax:
Practice Address - Street 1:96 JONATHAN LUCAS STREET
Practice Address - Street 2:SUITE 816
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29425-6240
Practice Address - Country:US
Practice Address - Phone:843-792-2529
Practice Address - Fax:843-792-2529
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-15
Last Update Date:2011-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program