Provider Demographics
NPI:1467104992
Name:PARKER, ABBY (APRN, CNP-BC)
Entity type:Individual
Prefix:
First Name:ABBY
Middle Name:
Last Name:PARKER
Suffix:
Gender:
Credentials:APRN, CNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 PATTON DR
Mailing Address - Street 2:
Mailing Address - City:PONCA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:74601-2030
Mailing Address - Country:US
Mailing Address - Phone:580-762-9355
Mailing Address - Fax:208-218-2199
Practice Address - Street 1:119 PATTON DR
Practice Address - Street 2:
Practice Address - City:PONCA CITY
Practice Address - State:OK
Practice Address - Zip Code:74601-2030
Practice Address - Country:US
Practice Address - Phone:580-762-9355
Practice Address - Fax:208-218-2199
Is Sole Proprietor?:No
Enumeration Date:2022-01-25
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0126064163W00000X, 363LS0200X
OK208033363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
No363LS0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerSchool