Provider Demographics
NPI:1386780401
Name:PARKER, PATRICIA ANN (NP)
Entity type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:ANN
Last Name:PARKER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 ORRISON ST
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01609-1027
Mailing Address - Country:US
Mailing Address - Phone:508-757-3889
Mailing Address - Fax:
Practice Address - Street 1:208 MAIN ST
Practice Address - Street 2:SUITE 101
Practice Address - City:MILFORD
Practice Address - State:MA
Practice Address - Zip Code:01757-2502
Practice Address - Country:US
Practice Address - Phone:508-458-3300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2012-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA201934363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAPA NP3873Medicare ID - Type Unspecified
MAP65515Medicare UPIN