Provider Demographics
NPI:1639644388
Name:PARKER, VALERIE WATERFIELD (MSN RDN)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:WATERFIELD
Last Name:PARKER
Suffix:
Gender:F
Credentials:MSN RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1021 CEDAR POINT RD
Mailing Address - Street 2:
Mailing Address - City:SANDUSKY
Mailing Address - State:OH
Mailing Address - Zip Code:44870-5255
Mailing Address - Country:US
Mailing Address - Phone:419-625-0818
Mailing Address - Fax:
Practice Address - Street 1:1021 CEDAR POINT RD
Practice Address - Street 2:
Practice Address - City:SANDUSKY
Practice Address - State:OH
Practice Address - Zip Code:44870-5255
Practice Address - Country:US
Practice Address - Phone:419-625-0818
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-09
Last Update Date:2018-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLD.8209133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered