Provider Demographics
NPI:1659465201
Name:PARKER, AMY N (RDMS, RVT, RDCS)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:N
Last Name:PARKER
Suffix:
Gender:F
Credentials:RDMS, RVT, RDCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2
Mailing Address - Street 2:
Mailing Address - City:RIENZI
Mailing Address - State:MS
Mailing Address - Zip Code:38865
Mailing Address - Country:US
Mailing Address - Phone:662-462-5919
Mailing Address - Fax:
Practice Address - Street 1:65 MAIN ST
Practice Address - Street 2:
Practice Address - City:RIENZI
Practice Address - State:MS
Practice Address - Zip Code:38865
Practice Address - Country:US
Practice Address - Phone:662-462-5919
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSMRT1561246XS1301X, 247100000X, 2471V0105X
2471S1302X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered246XS1301XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist CardiovascularSonography
Not Answered247100000XTechnologists, Technicians & Other Technical Service ProvidersRadiologic Technologist
Not Answered2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonography
Not Answered2471V0105XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistVascular Sonography