Individual
JOAN C PARKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1570 ACQUONI RD, SUITE 1, CHEROKEE, NC 28719
(828) 497-6318
Mailing address
PO BOX 1030, CHEROKEE, NC 28719-1030
(828) 497-6318
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0101121
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0101121
LICENSE
NC
05
—
891199Y
—
NC
Enumeration date
03/20/2006
Last updated
07/08/2007
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