Provider Demographics
NPI:1942594361
Name:PARKER, LEAH RENEE (NP)
Entity Type:Individual
Prefix:MRS
First Name:LEAH
Middle Name:RENEE
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 1:7697 CHARLOTTE HIGHWAY
Mailing Address - Street 2:
Mailing Address - City:INDIAN LAND
Mailing Address - State:SC
Mailing Address - Zip Code:29707
Mailing Address - Country:US
Mailing Address - Phone:866-389-2727
Mailing Address - Fax:704-541-5700
Practice Address - Street 1:7697 CHARLOTTE HIGHWAY
Practice Address - Street 2:
Practice Address - City:INDIAN LAND
Practice Address - State:SC
Practice Address - Zip Code:29707
Practice Address - Country:US
Practice Address - Phone:866-389-2727
Practice Address - Fax:704-541-5700
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-02
Last Update Date:2013-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC17474363LF0000X
NC235517363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily