Provider Demographics
NPI:1841237633
Name:PARKER, JENNIFER JEANNE (PA-C)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:JEANNE
Last Name:PARKER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:J
Other - Last Name:LOEFFLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:129 MCDOWELL ST
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28801-4434
Mailing Address - Country:US
Mailing Address - Phone:828-258-8800
Mailing Address - Fax:828-281-7178
Practice Address - Street 1:9 WALDEN RIDGE DR STE 10
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-8592
Practice Address - Country:US
Practice Address - Phone:833-365-7246
Practice Address - Fax:828-281-7178
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC001000425363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCQ68824Medicare UPIN
NC2766216Medicare ID - Type Unspecified