Individual
MRS. KALISSIA BENNETT PARKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
311 WINESAP PL, ABERDEEN, NC 28315-8300
(704) 690-5146
Mailing address
311 WINESAP PL, ABERDEEN, NC 28315-8300
(704) 690-5146
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
158967
NC
363LF0000X
Family Nurse Practitioner
28682
SC
363LF0000X
Family Nurse Practitioner
Primary
5019980
NC
Other
Enumeration date
01/23/2024
Last updated
09/08/2025
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