Provider Demographics
NPI:1831429919
Name:PARKER, DIONNE FULLER (ANP)
Entity type:Individual
Prefix:MS
First Name:DIONNE
Middle Name:FULLER
Last Name:PARKER
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 WESTVIEW CRES
Mailing Address - Street 2:
Mailing Address - City:GENESEO
Mailing Address - State:NY
Mailing Address - Zip Code:14454-1012
Mailing Address - Country:US
Mailing Address - Phone:585-243-3202
Mailing Address - Fax:
Practice Address - Street 1:4520 GENESEE ST
Practice Address - Street 2:ROUTE 63
Practice Address - City:GENESEO
Practice Address - State:NY
Practice Address - Zip Code:14454-1058
Practice Address - Country:US
Practice Address - Phone:585-243-3120
Practice Address - Fax:585-243-1189
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-12
Last Update Date:2010-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF300276-1363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health