Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 0024082624 | VA |
NPI | 1003025727 |
---|---|
Provider Name | Catherine Campbell Parker |
First Address | Roanoke, VA 24019-6729 |
Second Address | Roanoke, VA 24017-2716 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/05/2007 |
Last Update Date | 27/12/2012 |