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Organization

LILLIAN DAVENPORT PARKER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. LILLIAN GRACE PARKER CNSPMH (CLINICAL NURSE SPECIALIST)
(770) 987-1881
Entity
Organization

Contact information

Practice address
3629 WINDMILL RD, ELLENWOOD, GA 30294-2106
(770) 987-1881
Mailing address
3629 WINDMILL RD, ELLENWOOD, GA 30294-2106
(770) 987-1881

Taxonomy

Speciality
Code
Description
License number
State
364SP0807X
Child & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist
Primary
RN052630 CNSPMH
GA

Other

Enumeration date
01/09/2007
Last updated
06/20/2008
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