Provider Demographics
NPI:1568861375
Name:PARKER, D'LITA MICHELLE (APRN)
Entity Type:Individual
Prefix:
First Name:D'LITA
Middle Name:MICHELLE
Last Name:PARKER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:619 ANN AVE
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66101-3038
Mailing Address - Country:US
Mailing Address - Phone:913-573-8840
Mailing Address - Fax:
Practice Address - Street 1:619 ANN AVE
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66101-3038
Practice Address - Country:US
Practice Address - Phone:913-573-8840
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-18
Last Update Date:2014-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53-76422-111363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health