Individual
MRS. KIMBERLY GASTON PARKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
140 BRIDGES RD STE F, MAULDIN, SC 29662-3260
(864) 605-1449
(864) 515-4820
Mailing address
140 BRIDGES RD STE F, MAULDIN, SC 29662-3260
(864) 605-1449
(864) 515-4820
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
1360
SC
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
1360
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
571049338
BLUE CROSS SC
—
Enumeration date
07/12/2006
Last updated
11/03/2023
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