Individual
MRS. ERICA NICOLE PARKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.-C.
Contact information
Practice address
5480 BIG TYLER RD, CROSS LANES, WV 25313-1116
(304) 776-2409
(304) 776-2023
Mailing address
5480 BIG TYLER RD, CROSS LANES, WV 25313-1116
(304) 776-2409
(304) 776-2023
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
01141
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01141
WV LICENSC
WV
Enumeration date
07/14/2005
Last updated
06/12/2024
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