Provider Demographics
NPI:1841478476
Name:PARKER, ELIZABETH N (PA-C)
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:N
Last Name:PARKER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:ELIZABETH
Other - Middle Name:NICOLE
Other - Last Name:PERKEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:PO BOX 32569
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37930-2569
Mailing Address - Country:US
Mailing Address - Phone:865-694-0062
Mailing Address - Fax:865-694-7907
Practice Address - Street 1:9161 MIDDLEBROOK PIKE
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37923-1438
Practice Address - Country:US
Practice Address - Phone:865-694-2900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-06
Last Update Date:2014-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1639363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1507481Medicaid
TN103I970785Medicare PIN
TN1507481Medicaid