Provider Demographics
NPI:1528896735
Name:PARKER, KASSIDY ANN (RN, BSN, CCRN)
Entity type:Individual
Prefix:MRS
First Name:KASSIDY
Middle Name:ANN
Last Name:PARKER
Suffix:
Gender:F
Credentials:RN, BSN, CCRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:229 ANN FRANCIS DR
Mailing Address - Street 2:
Mailing Address - City:STONEWALL
Mailing Address - State:LA
Mailing Address - Zip Code:71078-9679
Mailing Address - Country:US
Mailing Address - Phone:318-286-8451
Mailing Address - Fax:
Practice Address - Street 1:229 ANN FRANCIS DR
Practice Address - Street 2:
Practice Address - City:STONEWALL
Practice Address - State:LA
Practice Address - Zip Code:71078-9679
Practice Address - Country:US
Practice Address - Phone:318-286-8451
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-22
Last Update Date:2024-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA208957163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine