Provider Demographics
NPI:1417467440
Name:PARKER, KARLIE L
Entity Type:Individual
Prefix:
First Name:KARLIE
Middle Name:L
Last Name:PARKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 W 13TH ST
Mailing Address - Street 2:
Mailing Address - City:HARPER
Mailing Address - State:KS
Mailing Address - Zip Code:67058-1401
Mailing Address - Country:US
Mailing Address - Phone:620-896-7324
Mailing Address - Fax:620-896-7186
Practice Address - Street 1:700 W 13TH ST
Practice Address - Street 2:
Practice Address - City:HARPER
Practice Address - State:KS
Practice Address - Zip Code:67058-1401
Practice Address - Country:US
Practice Address - Phone:620-896-7324
Practice Address - Fax:620-896-7186
Is Sole Proprietor?:No
Enumeration Date:2017-10-04
Last Update Date:2017-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS77866363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner