Provider Demographics
NPI:1386114924
Name:PARKER, REBECCA LYN (PHARM D, BCPS,CDCES)
Entity type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:LYN
Last Name:PARKER
Suffix:
Gender:
Credentials:PHARM D, BCPS,CDCES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 PERIMETER PKWY
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31210-0887
Mailing Address - Country:US
Mailing Address - Phone:478-832-6148
Mailing Address - Fax:
Practice Address - Street 1:111 PERIMETER PKWY
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31210-0887
Practice Address - Country:US
Practice Address - Phone:478-832-6148
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-27
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0910261835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
1111111111Other1111111111