Individual
PENNY PARKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4234 9TH AVENUE CIR S, FARGO, ND 58103-2090
(701) 429-4874
Mailing address
4234 9TH AVENUE CIR S, FARGO, ND 58103-2090
(701) 429-4874
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
—
—
3747A0650X
Attendant Care Provider
—
—
3747P1801X
Personal Care Attendant
—
—
374U00000X
Home Health Aide
—
—
376K00000X
Nurse's Aide
Primary
1524-586-731
ND
Other
Enumeration date
07/02/2012
Last updated
01/16/2014
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