Individual
MRS. DIANE MUDGE PARKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.N.,W.H.N.P.
Contact information
Practice address
500 S MAIN ST STE 113, MOORESVILLE, NC 28115-3228
(704) 799-5433
(704) 706-2446
Mailing address
500 S MAIN ST STE 113, MOORESVILLE, NC 28115-3228
(704) 799-5433
(704) 706-2446
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
110557
NC
363LF0000X
Family Nurse Practitioner
Primary
940100
NC
363LW0102X
Women's Health Nurse Practitioner
940100
NC
367A00000X
Advanced Practice Midwife
337
NC
Other
Enumeration date
08/01/2007
Last updated
07/28/2023
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