Provider Demographics
NPI:1770883670
Name:PARKS, NANCY L (RPH)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:L
Last Name:PARKS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1955 S SHERIDAN BLVD
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80227-3715
Mailing Address - Country:US
Mailing Address - Phone:303-989-9894
Mailing Address - Fax:303-989-6135
Practice Address - Street 1:1955 S SHERIDAN BLVD
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80227-3715
Practice Address - Country:US
Practice Address - Phone:303-989-9894
Practice Address - Fax:303-989-6135
Is Sole Proprietor?:No
Enumeration Date:2010-10-25
Last Update Date:2010-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO14528183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist