Individual
LYNN RENAY PARKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
65 BERGEN ST, SUITE 1118, NEWARK, NJ 07107-3001
(973) 972-8946
Mailing address
284 E LAKE AVE, RAHWAY, NJ 07065-4942
(732) 259-5156
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
26NJ00084000
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0230375
MEDICAID
NJ
Enumeration date
01/16/2007
Last updated
01/09/2012
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