Individual
DAVID PARKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
R.N.
Contact information
Practice address
4224 EDMORE RD, WATERFORD, MI 48329-3816
(248) 802-3508
Mailing address
4224 EDMORE RD, WATERFORD, MI 48329-3816
(248) 802-3508
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
47-04-192152
MI
163WH0200X
Home Health Registered Nurse
47-04-192152
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
E8461L
DEPARTMENT OF LICENSING AND REGULATORY AFFAIRS
—
Enumeration date
06/29/2016
Last updated
06/29/2016
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