Provider Demographics
NPI:1982684791
Name:PARKS, JOYCE A (ARNP)
Entity Type:Individual
Prefix:
First Name:JOYCE
Middle Name:A
Last Name:PARKS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1014
Mailing Address - Street 2:
Mailing Address - City:ELFERS
Mailing Address - State:FL
Mailing Address - Zip Code:34680-1014
Mailing Address - Country:US
Mailing Address - Phone:727-849-2005
Mailing Address - Fax:727-849-2087
Practice Address - Street 1:4821 US HIGHWAY 19 STE 1
Practice Address - Street 2:
Practice Address - City:NEW PRT RCHY
Practice Address - State:FL
Practice Address - Zip Code:34652-4259
Practice Address - Country:US
Practice Address - Phone:727-849-2005
Practice Address - Fax:727-849-2087
Is Sole Proprietor?:No
Enumeration Date:2006-01-18
Last Update Date:2013-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP1196942163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY7415YMedicare ID - Type UnspecifiedMEDICARE