Provider Demographics
NPI:1639517659
Name:PARKER, SHEILA ANNETTE (CPA, IPP)
Entity Type:Individual
Prefix:MS
First Name:SHEILA
Middle Name:ANNETTE
Last Name:PARKER
Suffix:
Gender:F
Credentials:CPA, IPP
Other - Prefix:
Other - First Name:SHEILA
Other - Middle Name:ANNETTE
Other - Last Name:TEAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CPA
Mailing Address - Street 1:222 LA VETA DR NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87108-1615
Mailing Address - Country:US
Mailing Address - Phone:505-312-8815
Mailing Address - Fax:
Practice Address - Street 1:222 LA VETA DR NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87108-1615
Practice Address - Country:US
Practice Address - Phone:505-312-8815
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-12
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM45831911744R1102X, 2083P0901X, 103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
No1744R1102XOther Service ProvidersSpecialistResearch Study
No2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM7115OtherOFFICE OF JUVENILE JUSTICE PROGRAM