1922098102 NPI number — MS. MARCIA DEBRA PARKER RN

Table of content: MS. MARCIA DEBRA PARKER RN (NPI 1922098102)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1922098102 NPI number — MS. MARCIA DEBRA PARKER RN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PARKER
Provider First Name:
MARCIA
Provider Middle Name:
DEBRA
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
RN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
KINSELLA
Provider Other First Name:
MARCIA
Provider Other Middle Name:
DEBRA
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1922098102
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2501 OAKINGTON ST
Provider Second Line Business Mailing Address:
KIRK US ARMY HEALTH CLINIC
Provider Business Mailing Address City Name:
ABERDEEN PROVING GROUND
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21005-5131
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-278-1986
Provider Business Mailing Address Fax Number:
410-278-1783

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2501 OAKINGTON ST
Provider Second Line Business Practice Location Address:
KIRK US ARMY HEALTH CLINIC
Provider Business Practice Location Address City Name:
ABERDEEN PROVING GROUND
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21005-5131
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-278-1986
Provider Business Practice Location Address Fax Number:
410-278-1783
Provider Enumeration Date:
10/27/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 163W00000X , with the licence number:  R092537 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)