Provider Demographics
NPI:1740709625
Name:PARKER, REBECCA ANN (APRN, FNP-C)
Entity type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:ANN
Last Name:PARKER
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:323 FOREST HILLS DR
Mailing Address - Street 2:
Mailing Address - City:HALLSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75650-5022
Mailing Address - Country:US
Mailing Address - Phone:903-720-7746
Mailing Address - Fax:
Practice Address - Street 1:14332 STATE HIGHWAY 31 E
Practice Address - Street 2:
Practice Address - City:BROWNSBORO
Practice Address - State:TX
Practice Address - Zip Code:75756-6749
Practice Address - Country:US
Practice Address - Phone:903-852-3663
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-12
Last Update Date:2018-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP134267363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily