Provider Demographics
NPI:1952401663
Name:PARKS-TAYLOR, NINA Z (CRNA)
Entity Type:Individual
Prefix:
First Name:NINA
Middle Name:Z
Last Name:PARKS-TAYLOR
Suffix:
Gender:F
Credentials:CRNA
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 5024
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10087-5024
Mailing Address - Country:US
Mailing Address - Phone:800-627-4470
Mailing Address - Fax:412-937-5710
Practice Address - Street 1:1 GUSTAVE L LEVY PL
Practice Address - Street 2:ANESTHESIOLOGY - BOX 1010
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-6504
Practice Address - Country:US
Practice Address - Phone:212-241-6426
Practice Address - Fax:212-876-3906
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-23
Last Update Date:2013-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY514901-1367500000X
NC120454367500000X
SC1959367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2628789AMedicare ID - Type Unspecified