Provider Demographics
NPI:1952659815
Name:PARKINS, MARION DELORES
Entity Type:Individual
Prefix:MS
First Name:MARION
Middle Name:DELORES
Last Name:PARKINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:306 W 112TH ST
Mailing Address - Street 2:3D
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10026-3246
Mailing Address - Country:US
Mailing Address - Phone:917-612-2711
Mailing Address - Fax:
Practice Address - Street 1:3050 REGENT BLVD
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75063-3196
Practice Address - Country:US
Practice Address - Phone:214-689-3600
Practice Address - Fax:214-689-3644
Is Sole Proprietor?:No
Enumeration Date:2012-08-27
Last Update Date:2012-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF337048-1363L00000X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care