Provider Demographics
NPI:1821839788
Name:PARKER, AUBREE (CPM, LDEM)
Entity type:Individual
Prefix:
First Name:AUBREE
Middle Name:
Last Name:PARKER
Suffix:
Gender:F
Credentials:CPM, LDEM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12966 S SPARROW HAWK LN
Mailing Address - Street 2:
Mailing Address - City:HERRIMAN
Mailing Address - State:UT
Mailing Address - Zip Code:84096-5735
Mailing Address - Country:US
Mailing Address - Phone:928-713-7179
Mailing Address - Fax:
Practice Address - Street 1:12966 S SPARROW HAWK LN
Practice Address - Street 2:
Practice Address - City:HERRIMAN
Practice Address - State:UT
Practice Address - Zip Code:84096-5735
Practice Address - Country:US
Practice Address - Phone:928-713-7179
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-04
Last Update Date:2024-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT13312405-3400175M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175M00000XOther Service ProvidersMidwife, Lay