Provider Demographics
NPI:1649421793
Name:PARKER, KATE
Entity Type:Individual
Prefix:MS
First Name:KATE
Middle Name:
Last Name:PARKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1455 E TROPICANA AVE STE 175B
Mailing Address - Street 2:B210
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-6507
Mailing Address - Country:US
Mailing Address - Phone:702-893-2001
Mailing Address - Fax:702-369-3334
Practice Address - Street 1:1455 E TROPICANA AVE STE 175B
Practice Address - Street 2:B210
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-6507
Practice Address - Country:US
Practice Address - Phone:702-893-2001
Practice Address - Fax:702-369-3334
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-07
Last Update Date:2016-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV2000139319253Z00000X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No253Z00000XAgenciesIn Home Supportive Care