KENNETH S PARKER (NPI# 1407964844) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407964844 |
| Entity Type | Individual |
| Full Name | KENNETH S PARKER |
| Credential | ACNP |
| Practice Address |
404 S 13th Ave Laurel MS 39440-4345 |
| Mailing Address |
415 S 28th Ave Hattiesburg MS 39401-7246 |
| Practice Telephone | 6014255544 |
| Practice Fax Number | 6014255525 |
| Mailing Telephone | 6014255544 |
| Mailing Fax Number | 6015795240 |
| Enumeration Date | 2006-08-27 |
| Last Update Date | 2020-06-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363L00000X | Nurse Practitioner | R851488 | MS | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
851488 | MS | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 02684504 | 05 | |
| MS | AMERICAN ADMIN GROUP | 3494930 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295179661 | Kenneth W Parker Sr. | Nurse's Aide | 1783 Lakenoll Dr, Cincinnati, OH 45231-5115 | 2013-04-29 |
| 1689920373 | Kenneth E Parker | Counselor | 101 Blue Vis, Cibolo, TX 78108-4255 | 2012-07-31 |
| 1518253426 | Kenneth Parker IIi | Pharmacist | 10478 N Nc Highway 109, Winston Salem, NC 27107-9634 | 2011-06-20 |
| 1013126507 | Kenneth Wayne Parker | Chiropractor | 12453 Timberland Blvd, Suite 105, Fort Worth, TX 76244-5208 | 2007-05-21 |
| 1568504058 | Kenneth C. Parker | Audiologist-Hearing Aid Fitter | 6151 Shallowford Rd Ste 104, Chattanooga, TN 37421-7803 | 2007-02-13 |
| 1407942030 | Kenneth A Parker | Psychologist | 4710 Hermano Drive, Tarzana, CA 91356-4516 | 2006-10-04 |
| 1760493910 | Kenneth Parker | Social Worker | 11709 Tanglebriar Trl, Austin, TX 78750-1361 | 2006-08-11 |
| 1841256765 | Kenneth Carroll Parker | Otolaryngology | 36 Mcmillen Dr, Newark, OH 43055-1809 | 2006-04-21 |
| 1043208564 | Kenneth Eldon Parker | Chiropractor | 127 Avenue C, Ste A, Snohomish, WA 98290-2768 | 2005-10-10 |
| 1265866776 | Kenneth Michael Parker Jr. | Pharmacist | 2758 W 70th St, Shreveport, LA 71108-4502 | 2013-09-03 |
| Street Address |
404 S 13TH AVE |
| City | LAUREL |
| State | MS |
| Zip Code | 39440-4345 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780799965 | Wassim E Mouannes | Internal Medicine | 404 S 13th Ave, Laurel, MS 39440-4345 | 2006-08-20 |
| 1013567445 | Jessica Watson Lott | Nurse Practitioner | 404 S 13th Ave, Laurel, MS 39440-4345 | 2019-09-17 |
| 1063625325 | Bassam K Mechleb | Internal Medicine | 404 S 13th Ave, Laurel, MS 39440-4345 | 2007-05-07 |
| 1518020999 | Pain Treatment Center of Laurel LLC | Clinic/Center | 404 S 13th Ave, Laurel, MS 39440-4345 | 2006-12-18 |
| 1689763534 | Hattiesburg Clinic Pa | Internal Medicine | 404 S 13th Ave, Laurel, MS 39440-4345 | 2006-10-11 |
| 1538277843 | Joseph A Proli | Internal Medicine | 404 S 13th Ave, Laurel, MS 39440-4345 | 2006-08-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306323159 | Tender Loving Care Homecare LLC | Homemaker | 509 Central Ave Ste 224, Laurel, MS 39440 | 2018-07-24 |
| 1669837910 | Laurel Dental Properties | Dentist | 1925 Pine Belt Drive, Laurel, MS 39440 | 2015-12-30 |
| 1215282991 | South Central Regional Medical Center | Clinic/Center | 525 Wayne Drive, Laurel, MS 39440 | 2012-07-18 |
| 1568721215 | Terry Ratcliff Perkins | Counselor | 5192 Hwy 11 North, Laurel, MS 39440 | 2012-05-15 |
| 1437453057 | Alexander Milne Home for Women | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 616 East 19th Street, Laurel, MS 39440 | 2010-12-23 |
| 1710135629 | Jeffrey R. Moffett | Nurse Practitioner | 3115 Audubon Dr, Laurel, MS 39440 | 2008-09-04 |
| 1003096785 | Family Health Center, Inc | Obstetrics & Gynecology | 103 S. 12th Avenue, Laurel, MS 39440 | 2007-11-09 |
| 1669672143 | Laurel Urology Clinic Pa | Urology | 304 S 10th Ave, Laurel, MS 39440 | 2007-07-23 |
| 1093912370 | Tanweer Hussain Majid | Surgery | 1007 Jefferson Street, Laurel, MS 39440 | 2007-06-29 |
| 1780889923 | Hattiesburg Eye Clinic, Pa | Ophthalmology | 1431 North 10th St, Suite 1, Laurel, MS 39440 | 2007-06-18 |
| Find all providers in zip 39440 | ||||
| Taxonomy Code | 363LA2100X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Acute Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730799578 | Holly Marie White | Nurse Practitioner | 1220 Jefferson St, Laurel, MS 39440-4355 | 2020-08-06 |
| 1295884617 | Hannah E Mccallum | Nurse Practitioner | 319 S 13th Ave, Laurel, MS 39440-4342 | 2007-01-09 |
| 1043257942 | Karen A Lininger | Nurse Practitioner | 1220 Jefferson St, Laurel, MS 39440-4355 | 2006-05-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306450358 | Sara Leanne Davis | Nurse Practitioner | 230 Possum Ridge Rd, Hollandale, MS 38748-3755 | 2020-09-06 |
| 1598385130 | Christy Busby | Nurse Practitioner | 128 Warren St, Pontotoc, MS 38863-1519 | 2020-04-23 |
| 1104459742 | Amanda Paige Michael | Nurse Practitioner | 200 Quail Run, Booneville, MS 38829-9001 | 2020-02-21 |
| 1891328340 | U Matter LLC | Nurse Practitioner | 2440 N Hills St Ste 126, Meridian, MS 39305-2634 | 2020-02-12 |
| 1255978367 | Tanya Haley Mcgee | Nurse Practitioner | 229 Old Yorkville Rd S, Columbus, MS 39702-8440 | 2019-12-08 |
| 1447893888 | Spectrum The Other Clinic | Nurse Practitioner | 2910 Magnolia Pl, Hattiesburg, MS 39402-2428 | 2019-10-17 |
| 1053962068 | Lauren Lanier Guthrie | Nurse Practitioner | 102 Friars Cv, Clinton, MS 39056-3411 | 2019-09-23 |
| 1588212229 | David Buckheister | Nurse Practitioner | 612 Liz Cir, Gulfport, MS 39503-3712 | 2019-08-27 |
| 1821583196 | Amanda Houston Trent | Nurse Practitioner | 4381 S Eason Blvd Ste 203, Tupelo, MS 38801-6557 | 2018-06-28 |
| 1093224446 | Jennifer Hurley | Nurse Practitioner | 2809n Denny Ave, Pascagoula, MS 39581-5301 | 2017-09-28 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on KENNETH S PARKER.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.