Provider Demographics
NPI:1417143470
Name:PARKER, LILA ALLISON (RN)
Entity Type:Individual
Prefix:MRS
First Name:LILA
Middle Name:ALLISON
Last Name:PARKER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2801 TIMBERMIST DR
Mailing Address - Street 2:
Mailing Address - City:BENTON
Mailing Address - State:AR
Mailing Address - Zip Code:72015-4790
Mailing Address - Country:US
Mailing Address - Phone:501-776-1632
Mailing Address - Fax:
Practice Address - Street 1:2801 TIMBERMIST DR
Practice Address - Street 2:
Practice Address - City:BENTON
Practice Address - State:AR
Practice Address - Zip Code:72015-4790
Practice Address - Country:US
Practice Address - Phone:501-776-1632
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-24
Last Update Date:2007-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARR68270163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse