Provider Demographics
NPI:1255930699
Name:PARKER, LIANE (RN CPHM)
Entity type:Individual
Prefix:
First Name:LIANE
Middle Name:
Last Name:PARKER
Suffix:
Gender:F
Credentials:RN CPHM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4035 CINWOOD ST NW
Mailing Address - Street 2:
Mailing Address - City:MASSILLON
Mailing Address - State:OH
Mailing Address - Zip Code:44646-5114
Mailing Address - Country:US
Mailing Address - Phone:740-994-1811
Mailing Address - Fax:740-888-0306
Practice Address - Street 1:4035 CINWOOD ST NW
Practice Address - Street 2:
Practice Address - City:MASSILLON
Practice Address - State:OH
Practice Address - Zip Code:44646-5114
Practice Address - Country:US
Practice Address - Phone:740-994-1811
Practice Address - Fax:740-888-0306
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-17
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.465068163W00000X
TN242276163WC0400X, 163W00000X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WC0400XNursing Service ProvidersRegistered NurseCase Management
No171M00000XOther Service ProvidersCase Manager/Care Coordinator