Provider Demographics
NPI:1861131237
Name:PARKS, DYANA LYNNE
Entity type:Individual
Prefix:
First Name:DYANA
Middle Name:LYNNE
Last Name:PARKS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9755 SILVER SKY PKWY APT 3508
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89506-2225
Mailing Address - Country:US
Mailing Address - Phone:775-224-6796
Mailing Address - Fax:
Practice Address - Street 1:9755 SILVER SKY PKWY APT 3508
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89506-2225
Practice Address - Country:US
Practice Address - Phone:775-224-6796
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-02
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide