Provider Demographics
NPI:1235635822
Name:PARKER, DEBRA LOUISE (DNP, RN)
Entity type:Individual
Prefix:DR
First Name:DEBRA
Middle Name:LOUISE
Last Name:PARKER
Suffix:
Gender:F
Credentials:DNP, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4050 N WEAVER RD
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:IN
Mailing Address - Zip Code:46952-8616
Mailing Address - Country:US
Mailing Address - Phone:765-618-5827
Mailing Address - Fax:
Practice Address - Street 1:30401 MOUNTAIN LN
Practice Address - Street 2:
Practice Address - City:WATERFORD
Practice Address - State:WI
Practice Address - Zip Code:53185-3442
Practice Address - Country:US
Practice Address - Phone:765-618-5827
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-03
Last Update Date:2018-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI240809-30163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse