Provider Demographics
NPI:1255451332
Name:PARKER, MARTHA JENNIFER (NURSE PRACTITIONER)
Entity type:Individual
Prefix:MS
First Name:MARTHA
Middle Name:JENNIFER
Last Name:PARKER
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
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Mailing Address - Street 1:1280 ATHENS ST
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30507-7000
Mailing Address - Country:US
Mailing Address - Phone:770-535-5882
Mailing Address - Fax:770-535-5749
Practice Address - Street 1:1280 ATHENS ST
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30507-7000
Practice Address - Country:US
Practice Address - Phone:770-535-5882
Practice Address - Fax:770-535-5749
Is Sole Proprietor?:No
Enumeration Date:2007-03-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GARN044380363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner