Individual
SANDRA L PARKS
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1123 N 10TH ST, BEATRICE, NE 68310-2001
(402) 228-4295
(402) 228-3702
Mailing address
1123 N 10TH ST, BEATRICE, NE 68310-2001
(402) 228-4295
(402) 228-3702
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
20911
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
47083307200
—
NE
Enumeration date
10/04/2005
Last updated
07/08/2007
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