Provider Demographics
NPI:1942492723
Name:PARKER, JANET L (FNP-BC)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:L
Last Name:PARKER
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 OLD MARLTON PIKE
Mailing Address - Street 2:SUITE 211
Mailing Address - City:MEDFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:08055-8772
Mailing Address - Country:US
Mailing Address - Phone:609-953-7500
Mailing Address - Fax:609-953-9085
Practice Address - Street 1:103 OLD MARLTON PIKE
Practice Address - Street 2:SUITE 211
Practice Address - City:MEDFORD
Practice Address - State:NJ
Practice Address - Zip Code:08055-8772
Practice Address - Country:US
Practice Address - Phone:609-953-7500
Practice Address - Fax:609-953-9085
Is Sole Proprietor?:No
Enumeration Date:2007-08-15
Last Update Date:2014-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NN05592300363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ12977XVAMedicare UPIN