Individual
MARYA JANELLE PARKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3006 KNIGHTBRIDGE RD, COLUMBIA, SC 29223-2131
(803) 736-8142
Mailing address
3006 KNIGHTBRIDGE RD, COLUMBIA, SC 29223-2131
(803) 736-8142
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
20672
SC
363LP2300X
Primary Care Nurse Practitioner
Primary
201910419NP-PP
OR
Other
Enumeration date
04/25/2017
Last updated
11/04/2020
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