Provider Demographics
NPI:1578180360
Name:PARKER, CARLY MARIE (ARNP)
Entity type:Individual
Prefix:
First Name:CARLY
Middle Name:MARIE
Last Name:PARKER
Suffix:
Gender:
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 N 2ND ST
Mailing Address - Street 2:
Mailing Address - City:WINTERSET
Mailing Address - State:IA
Mailing Address - Zip Code:50273-1509
Mailing Address - Country:US
Mailing Address - Phone:515-577-2913
Mailing Address - Fax:888-649-3210
Practice Address - Street 1:116 N 2ND ST
Practice Address - Street 2:
Practice Address - City:WINTERSET
Practice Address - State:IA
Practice Address - Zip Code:50273-1509
Practice Address - Country:US
Practice Address - Phone:515-577-2913
Practice Address - Fax:888-649-3210
Is Sole Proprietor?:No
Enumeration Date:2020-06-29
Last Update Date:2025-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA159469207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine