Provider Demographics
NPI:1790769636
Name:PARKER, ALISON (NP)
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:
Last Name:PARKER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 PORTER DR
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURY
Mailing Address - State:VT
Mailing Address - Zip Code:05753-8527
Mailing Address - Country:US
Mailing Address - Phone:802-388-8808
Mailing Address - Fax:802-388-8322
Practice Address - Street 1:82 CATAMOUNT PARK
Practice Address - Street 2:
Practice Address - City:MIDDLEBURY
Practice Address - State:VT
Practice Address - Zip Code:05753-1292
Practice Address - Country:US
Practice Address - Phone:802-388-7185
Practice Address - Fax:802-388-3445
Is Sole Proprietor?:No
Enumeration Date:2005-12-05
Last Update Date:2010-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT1010015322363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1009546Medicaid
NP4089Medicare ID - Type Unspecified
VT1009546Medicaid