Provider Demographics
NPI:1558775007
Name:PARKER, AMANDA (CNM, DNP)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:PARKER
Suffix:
Gender:F
Credentials:CNM, DNP
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 635283
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-5283
Mailing Address - Country:US
Mailing Address - Phone:812-496-8776
Mailing Address - Fax:812-537-9145
Practice Address - Street 1:98 ELM ST
Practice Address - Street 2:
Practice Address - City:LAWRENCEBURG
Practice Address - State:IN
Practice Address - Zip Code:47025-2048
Practice Address - Country:US
Practice Address - Phone:812-496-8776
Practice Address - Fax:812-537-9145
Is Sole Proprietor?:No
Enumeration Date:2014-06-12
Last Update Date:2023-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4009271367A00000X
IN09000243A367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife