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Individual

CHERYL ROSE PARKS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
45 THOMAS JOHNSON DR, SUITE 207, FREDERICK, MD 21702-4425
(301) 694-3400
(301) 694-3620
Mailing address
PO BOX 790058, SAINT LOUIS, MO 63179-0058
(636) 549-2380
(314) 569-5974

Taxonomy

Speciality
Code
Description
License number
State
364S00000X
Clinical Nurse Specialist
Primary
RO68640
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
KBC1CH
CAREFIRST BCBS
MD
01
P00137653
MEDICARE RAILROAD (PTAN CJ8689)
MD
01
P00687678
MEDICARE RAILROAD (PTAN DD6120)
MD
01
S417-0007
CAREFIRST BCBS
DC
Enumeration date
11/30/2005
Last updated
03/17/2010
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