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Individual

MS. JOHNNIE WINIFRED PARKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
1081 E 18TH ST, ROLLA, MO 65401-2448
(573) 458-7800
Mailing address
1081 E 18TH ST, ROLLA, MO 65401-2448
(573) 426-4455

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
151094
MO
363LF0000X
Family Nurse Practitioner
Primary
2017024747
MO

Other

Enumeration date
02/10/2017
Last updated
05/06/2021
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