Provider Demographics
NPI:1801966486
Name:PARKER, JANICE LANIER (CRNP)
Entity type:Individual
Prefix:
First Name:JANICE
Middle Name:LANIER
Last Name:PARKER
Suffix:
Gender:F
Credentials:CRNP
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 97
Mailing Address - Street 2:
Mailing Address - City:GADSDEN
Mailing Address - State:AL
Mailing Address - Zip Code:35902-0097
Mailing Address - Country:US
Mailing Address - Phone:256-492-0131
Mailing Address - Fax:
Practice Address - Street 1:1316 NOBLE ST
Practice Address - Street 2:
Practice Address - City:ANNISTON
Practice Address - State:AL
Practice Address - Zip Code:36201-4643
Practice Address - Country:US
Practice Address - Phone:256-236-0221
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2011-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-046166171W00000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No171W00000XOther Service ProvidersContractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL114377Medicaid
AL102I505264Medicare PIN
AL114377Medicaid
AL102I505266Medicare PIN