Provider Demographics
NPI:1629840897
Name:PARKER, JACQUELINE PARAMORE (FNP)
Entity Type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:PARAMORE
Last Name:PARKER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1411 ENGLISH CT
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28411-7059
Mailing Address - Country:US
Mailing Address - Phone:910-279-0024
Mailing Address - Fax:
Practice Address - Street 1:803 S WALKER ST
Practice Address - Street 2:
Practice Address - City:BURGAW
Practice Address - State:NC
Practice Address - Zip Code:28425-5001
Practice Address - Country:US
Practice Address - Phone:910-259-1207
Practice Address - Fax:910-259-2138
Is Sole Proprietor?:No
Enumeration Date:2023-10-23
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5019258363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily