Provider Demographics
NPI:1477237782
Name:PARKER, KELI ELAINE
Entity Type:Individual
Prefix:
First Name:KELI
Middle Name:ELAINE
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:PO BOX 452
Mailing Address - Street 2:
Mailing Address - City:WAYNESFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45896-0452
Mailing Address - Country:US
Mailing Address - Phone:419-303-1644
Mailing Address - Fax:
Practice Address - Street 1:217 E WAPAKONETA ST
Practice Address - Street 2:
Practice Address - City:WAYNESFIELD
Practice Address - State:OH
Practice Address - Zip Code:45896-9484
Practice Address - Country:US
Practice Address - Phone:419-303-1644
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-15
Last Update Date:2023-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant