Provider Demographics
NPI:1790227296
Name:PARKER, JEANETTE (NP-C, DNP, APRN)
Entity Type:Individual
Prefix:DR
First Name:JEANETTE
Middle Name:
Last Name:PARKER
Suffix:
Gender:F
Credentials:NP-C, DNP, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:816 HIGH BATTERY CIR
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-7879
Mailing Address - Country:US
Mailing Address - Phone:843-860-5533
Mailing Address - Fax:
Practice Address - Street 1:816 HIGH BATTERY CIR
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-7879
Practice Address - Country:US
Practice Address - Phone:843-860-5533
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-15
Last Update Date:2016-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC20371363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily