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Individual

MRS. NATASHA ANNE NICHOLS PARKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
380 HOSPITAL DR., SUITE 410, MACON, GA 31217-8014
(478) 746-5644
(478) 745-4849
Mailing address
P.O. BOX 2564, MACON, GA 31203
(478) 746-5644
(478) 745-4849

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN130252
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
247000912A
GA
01
551989
WELLCARE
GA
01
580628385
TRICARE
GA
01
P00855849
RAILROAD MEDICARE
GA
Enumeration date
06/02/2010
Last updated
12/14/2010
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