Provider Demographics
NPI:1518633627
Name:WHITE, PARKER LYNN
Entity Type:Individual
Prefix:
First Name:PARKER
Middle Name:LYNN
Last Name:WHITE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:PARKER
Other - Middle Name:LYNN
Other - Last Name:PALSA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:128 VIRGINIA WAY
Mailing Address - Street 2:
Mailing Address - City:SEARCY
Mailing Address - State:AR
Mailing Address - Zip Code:72143-8654
Mailing Address - Country:US
Mailing Address - Phone:870-723-4639
Mailing Address - Fax:
Practice Address - Street 1:1303 MCLAIN ST
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:AR
Practice Address - Zip Code:72112-3633
Practice Address - Country:US
Practice Address - Phone:870-523-5888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-18
Last Update Date:2021-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD15875183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist