Provider Demographics
NPI:1770239436
Name:PARKER, AMITY (MSN)
Entity Type:Individual
Prefix:
First Name:AMITY
Middle Name:
Last Name:PARKER
Suffix:
Gender:F
Credentials:MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2004 HAYES ST STE 800
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-2659
Mailing Address - Country:US
Mailing Address - Phone:615-329-0570
Mailing Address - Fax:615-329-0579
Practice Address - Street 1:103 PHYSICIANS WAY STE 120
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:TN
Practice Address - Zip Code:37090-4134
Practice Address - Country:US
Practice Address - Phone:615-453-5623
Practice Address - Fax:615-453-8592
Is Sole Proprietor?:No
Enumeration Date:2022-02-22
Last Update Date:2022-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN31208363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily