Provider Demographics
NPI:1639934698
Name:PARKER, JAMES LAVERNE (ARNP, PMHNP-BC)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:LAVERNE
Last Name:PARKER
Suffix:
Gender:M
Credentials:ARNP, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:855 A AVE NE STE 300
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52402-5064
Mailing Address - Country:US
Mailing Address - Phone:319-368-9301
Mailing Address - Fax:319-739-4380
Practice Address - Street 1:855 A AVE NE STE 300
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52402-5064
Practice Address - Country:US
Practice Address - Phone:319-368-9301
Practice Address - Fax:319-739-4380
Is Sole Proprietor?:No
Enumeration Date:2024-02-19
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAG178326363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health