Provider Demographics
NPI:1770370249
Name:PARKER, RILEY ANNE
Entity type:Individual
Prefix:
First Name:RILEY
Middle Name:ANNE
Last Name:PARKER
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3440 S NATIONAL AVE # 2020
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65807-7307
Mailing Address - Country:US
Mailing Address - Phone:417-725-0500
Mailing Address - Fax:417-725-0502
Practice Address - Street 1:3440 S NATIONAL AVE
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65807-7307
Practice Address - Country:US
Practice Address - Phone:417-886-5444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-21
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program