Individual
MRS. AMANDA JOLENE PARKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP
Contact information
Practice address
115 HUSTON DR STE 1, SHEPHERDSVILLE, KY 40165-7250
(502) 955-7311
(502) 955-9694
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3011178
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300057010
—
IN
05
—
50126162
—
KY
01
—
K224000
MEDICARE
KY
Enumeration date
03/11/2017
Last updated
09/21/2022
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