Provider Demographics
NPI:1710214721
Name:PARKER, MARK ANTHONY (PMHNP-BC)
Entity Type:Individual
Prefix:MR
First Name:MARK
Middle Name:ANTHONY
Last Name:PARKER
Suffix:
Gender:M
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22611 MARKEY CT
Mailing Address - Street 2:
Mailing Address - City:STERLING
Mailing Address - State:VA
Mailing Address - Zip Code:20166-6925
Mailing Address - Country:US
Mailing Address - Phone:703-249-4828
Mailing Address - Fax:
Practice Address - Street 1:22611 MARKEY CT STE 114
Practice Address - Street 2:
Practice Address - City:STERLING
Practice Address - State:VA
Practice Address - Zip Code:20166-6925
Practice Address - Country:US
Practice Address - Phone:703-249-4828
Practice Address - Fax:703-281-6888
Is Sole Proprietor?:No
Enumeration Date:2009-11-11
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024186581363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health