Individual
KELLIE R. PARKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1275 PROVIDENT DR, WARSAW, IN 46580-3265
(574) 269-4026
(574) 269-7444
Mailing address
2518 E DUPONT RD, FORT WAYNE, IN 46825-1675
(260) 432-4400
(260) 969-6898
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71007937A
IN
Other
Enumeration date
04/03/2018
Last updated
04/24/2018
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