Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 176B00000X | Midwife | 263988-4402 | UT |
N | 176B00000X | Midwife | APRN20109 | SC |
N | 363L00000X | Nurse Practitioner | 20109 | SC |
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 20109 | SC |
N | 363LW0102X | Nurse Practitioner - Women's Health | 20109 | SC |
NPI | 1083677207 |
---|---|
Provider Name | Melinda Gould Parker |
First Address | Myrtle Beach, SC 29579-7408 |
Second Address | Myrtle Beach, SC 29588-6810 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2006 |
Last Update Date | 30/03/2021 |