Provider Demographics
NPI:1457239253
Name:PARKER, AMY ANN (RN)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:ANN
Last Name:PARKER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1032 BALMORE DR
Mailing Address - Street 2:
Mailing Address - City:MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29579-3353
Mailing Address - Country:US
Mailing Address - Phone:843-467-0405
Mailing Address - Fax:
Practice Address - Street 1:1032 BALMORE DR
Practice Address - Street 2:
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29579-3353
Practice Address - Country:US
Practice Address - Phone:843-467-0405
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-21
Last Update Date:2025-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC250349163WN0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WN0800XNursing Service ProvidersRegistered NurseNeuroscience