Provider Demographics
NPI:1649542101
Name:PARKER, KIRSTEN FOSTER (ANP)
Entity type:Individual
Prefix:MRS
First Name:KIRSTEN
Middle Name:FOSTER
Last Name:PARKER
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:251 SUMMIT AVE
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14214-1933
Mailing Address - Country:US
Mailing Address - Phone:716-863-0231
Mailing Address - Fax:
Practice Address - Street 1:3332 WALDEN AVE
Practice Address - Street 2:
Practice Address - City:DEPEW
Practice Address - State:NY
Practice Address - Zip Code:14043-2400
Practice Address - Country:US
Practice Address - Phone:716-668-7051
Practice Address - Fax:716-668-7069
Is Sole Proprietor?:No
Enumeration Date:2012-01-31
Last Update Date:2012-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF305961-1363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health