Provider Demographics
NPI:1518646231
Name:PARKER, LYDIA FAITH
Entity Type:Individual
Prefix:
First Name:LYDIA
Middle Name:FAITH
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 1:501 W 14TH ST APT 308
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23224-2191
Mailing Address - Country:US
Mailing Address - Phone:315-530-5109
Mailing Address - Fax:
Practice Address - Street 1:501 W 14TH ST APT 308
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23224-2191
Practice Address - Country:US
Practice Address - Phone:315-530-5109
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-12
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist