Provider Demographics
NPI:1730664582
Name:PARKER, CHRISTIE ELLEN (NP)
Entity type:Individual
Prefix:
First Name:CHRISTIE
Middle Name:ELLEN
Last Name:PARKER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 KENNESTONE HOSPITAL BLVD
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-1120
Mailing Address - Country:US
Mailing Address - Phone:770-793-7899
Mailing Address - Fax:770-793-7856
Practice Address - Street 1:4630 JOHNSON FERRY PLACE
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30068-2063
Practice Address - Country:US
Practice Address - Phone:770-971-5870
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-27
Last Update Date:2021-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN187304363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology