Provider Demographics
NPI:1144477316
Name:PARKER, LAURA S (FNP-BC)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:S
Last Name:PARKER
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1915 FAIRGROVE CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:NC
Mailing Address - Zip Code:28658-8531
Mailing Address - Country:US
Mailing Address - Phone:828-468-3980
Mailing Address - Fax:828-994-4053
Practice Address - Street 1:3975 ROBINSON RD
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:NC
Practice Address - Zip Code:28658-9715
Practice Address - Country:US
Practice Address - Phone:828-466-0466
Practice Address - Fax:828-466-8862
Is Sole Proprietor?:No
Enumeration Date:2008-08-19
Last Update Date:2016-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5004042363L00000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7004208Medicaid
NC7004208Medicaid