Provider Demographics
NPI:1063103596
Name:PARKER, MELANIE BROOKE (CRNP)
Entity type:Individual
Prefix:MRS
First Name:MELANIE
Middle Name:BROOKE
Last Name:PARKER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3500 LAKEFRONT DR
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36695-8652
Mailing Address - Country:US
Mailing Address - Phone:251-472-6950
Mailing Address - Fax:
Practice Address - Street 1:3980G AIRPORT BLVD
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36608-2224
Practice Address - Country:US
Practice Address - Phone:251-318-2603
Practice Address - Fax:251-318-2604
Is Sole Proprietor?:No
Enumeration Date:2023-05-16
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-166085363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics