Provider Demographics
NPI:1881872885
Name:PARKER, JENORA LYN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JENORA
Middle Name:LYN
Last Name:PARKER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8606 PHILADELPHIA RD
Mailing Address - Street 2:
Mailing Address - City:ROSEDALE
Mailing Address - State:MD
Mailing Address - Zip Code:21237
Mailing Address - Country:US
Mailing Address - Phone:410-238-7705
Mailing Address - Fax:410-238-7958
Practice Address - Street 1:8606 PHILADELPHIA RD
Practice Address - Street 2:
Practice Address - City:ROSEDALE
Practice Address - State:MD
Practice Address - Zip Code:21237-3021
Practice Address - Country:US
Practice Address - Phone:410-238-7705
Practice Address - Fax:410-238-7958
Is Sole Proprietor?:No
Enumeration Date:2008-02-01
Last Update Date:2015-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY050504-1183500000X
MD18978183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY050504-1OtherPHARMACIST LICENSE NUMBER