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Individual

PAMELA J PARKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP-BC

Contact information

Practice address
800 GRAND CENTRAL MALL, SUITE 4, VIENNA, WV 26105-4100
(304) 485-4439
(304) 485-6489
Mailing address
800 GRAND CENTRAL MALL, SUITE 4, VIENNA, WV 26105-4100
(304) 485-4439
(304) 485-6489

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
42833
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0070391
OH
05
3810024243
WV
01
P01126466
MEDICARE RR
WV
Enumeration date
08/13/2012
Last updated
02/07/2013
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