Provider Demographics
NPI:1649403569
Name:PARKMAN, MARIE E (ARNP)
Entity type:Individual
Prefix:
First Name:MARIE
Middle Name:E
Last Name:PARKMAN
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 102101
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30368-2101
Mailing Address - Country:US
Mailing Address - Phone:863-603-6542
Mailing Address - Fax:863-603-6529
Practice Address - Street 1:1417 LAKELAND HILLS BLVD
Practice Address - Street 2:STE 204
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33805-3200
Practice Address - Country:US
Practice Address - Phone:863-603-6542
Practice Address - Fax:860-603-6529
Is Sole Proprietor?:No
Enumeration Date:2009-08-26
Last Update Date:2011-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9188434363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLARNP9188434OtherSTATE LIC