Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0205X | Pediatric Endocrinologist | L7838 | TX |
NPI | 1043302896 |
---|---|
Provider Name | Katrina L Parker |
First Address | Atlanta, GA 30303 |
Second Address | Atlanta, GA 30303 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/09/2006 |
Last Update Date | 18/11/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
163452901 | (05) | TX |
E38721 | (02) | TX |