Provider Demographics
NPI:1922302827
Name:PARKS, AMANDA B (MSN, ARNP)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:B
Last Name:PARKS
Suffix:
Gender:F
Credentials:MSN, ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5600 MISSION DR
Mailing Address - Street 2:
Mailing Address - City:MISSION HILLS
Mailing Address - State:KS
Mailing Address - Zip Code:66208-1134
Mailing Address - Country:US
Mailing Address - Phone:913-599-3828
Mailing Address - Fax:913-599-3451
Practice Address - Street 1:10550 QUIVIRA RD
Practice Address - Street 2:SUITE 530
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66215-2306
Practice Address - Country:US
Practice Address - Phone:913-599-3828
Practice Address - Fax:913-599-3451
Is Sole Proprietor?:No
Enumeration Date:2011-01-06
Last Update Date:2017-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS5375179012363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health