Provider Demographics
NPI:1528732591
Name:PARKER, KATHLEEN (PA)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:
Last Name:PARKER
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1926 ALCOA HWY STE F210
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37920-1545
Mailing Address - Country:US
Mailing Address - Phone:865-305-2495
Mailing Address - Fax:865-305-2496
Practice Address - Street 1:1926 ALCOA HWY STE F210
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37920-1545
Practice Address - Country:US
Practice Address - Phone:865-305-2495
Practice Address - Fax:865-305-2496
Is Sole Proprietor?:No
Enumeration Date:2021-08-04
Last Update Date:2025-09-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN6029363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical