Provider Demographics
NPI:1306253455
Name:PARKER, KERRI (APRN-CNP)
Entity type:Individual
Prefix:
First Name:KERRI
Middle Name:
Last Name:PARKER
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1092
Mailing Address - Street 2:101 W GLAYDAS AVE
Mailing Address - City:HOOKER
Mailing Address - State:OK
Mailing Address - Zip Code:73945-1092
Mailing Address - Country:US
Mailing Address - Phone:580-652-1100
Mailing Address - Fax:580-652-1102
Practice Address - Street 1:101 W GLAYDAS AVE
Practice Address - Street 2:
Practice Address - City:HOOKER
Practice Address - State:OK
Practice Address - Zip Code:73945-1092
Practice Address - Country:US
Practice Address - Phone:580-652-1100
Practice Address - Fax:580-652-1102
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-21
Last Update Date:2014-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK74479363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily