Provider Demographics
NPI:1194114611
Name:PARKES, KATHY (MSN, RN, IBCLC)
Entity type:Individual
Prefix:
First Name:KATHY
Middle Name:
Last Name:PARKES
Suffix:
Gender:F
Credentials:MSN, RN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5851 LOST CREEK ST.
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78247-1323
Mailing Address - Country:US
Mailing Address - Phone:210-834-5399
Mailing Address - Fax:
Practice Address - Street 1:5851 LOST CREEK ST.
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78247-1323
Practice Address - Country:US
Practice Address - Phone:210-834-5399
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-21
Last Update Date:2015-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX589693163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant