Provider Demographics
NPI:1003547845
Name:PARKIN, ELIZA DANSIE (RN)
Entity type:Individual
Prefix:MS
First Name:ELIZA
Middle Name:DANSIE
Last Name:PARKIN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MS
Other - First Name:ELIZA
Other - Middle Name:DANSIE
Other - Last Name:PARKIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:APRN, DNP
Mailing Address - Street 1:2218 S DALLIN ST
Mailing Address - Street 2:
Mailing Address - City:SLC
Mailing Address - State:UT
Mailing Address - Zip Code:84109-1119
Mailing Address - Country:US
Mailing Address - Phone:801-673-7088
Mailing Address - Fax:
Practice Address - Street 1:2218 S DALLIN ST
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84109-1119
Practice Address - Country:US
Practice Address - Phone:801-673-7088
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-22
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT11765743-3102163WX0200X
UT11765743-4405363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WX0200XNursing Service ProvidersRegistered NurseOncology