MRS. MANDI NICOLE PARKS


Address: 35629 Highway 72, Salem, MO 65560-7217
Phone: 5737298000

MRS. MANDI NICOLE PARKS (NPI# 1760966188) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1760966188
Entity Type Individual
Full Name MRS. MANDI NICOLE PARKS
Practice Address 35629 Highway 72
Salem
MO 65560-7217
Mailing Address Po Box 213
Salem
MO 65560-0213
Practice Telephone 5737298000
Enumeration Date 2018-09-21
Last Update Date 2018-10-03
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LF0000X Nurse Practitioner
Specialization: Family
2018036147 MO Physician Assistants & Advanced Practice Nursing Providers
N 390200000X Student in an Organized Health Care Education/Training Program Student, Health Care

Provider Secondary Practice Location

Address Telephone Number Fax Number
18950 Highway C, Lenox, MO 655419306 5732470715

Office Location

Street Address 35629 HIGHWAY 72
City SALEM
State MO
Zip Code 65560-7217

Providers in the same location

NPI Name Taxonomy Address Enumeration
1639177561 Salem Memorial Hospital General Acute Care Hospital 35629 Highway 72, Salem, MO 65560-7217 2005-07-13
1851891709 Jill Dean Occupational Therapy Assistant 35629 Highway 72, Salem, MO 65560-7217 2018-02-16
1902346240 Sarah Knott Physical Therapy Assistant 35629 Highway 72, Salem, MO 65560-7217 2017-03-06
1306226998 Zachary Moser Pharmacist 35629 Highway 72, Salem, MO 65560-7217 2015-06-09
1730566274 Melody Marie Montgomery Pharmacist 35629 Highway 72, Salem, MO 65560-7217 2015-05-05
1548682339 Nicole L Hancock Dietitian, Registered 35629 Highway 72, Salem, MO 65560-7217 2014-01-13
1891034229 Qmb Radiology LLC Radiologic Technologist 35629 Highway 72, Salem, MO 65560-7217 2013-02-05
1922345800 Salem Memorial Hospital Clinic/Center 35629 Highway 72, Building 1, Salem, MO 65560-7217 2013-01-11
1255661690 Radex, Inc Radiologic Technologist 35629 Highway 72, Salem, MO 65560-7217 2010-01-07
1114062387 Anne M Delonais-turner Emergency Medicine 35629 Highway 72, Salem, MO 65560-7217 2007-02-21
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1174087985 Brenda Gott Nurse Practitioner 3103 Hh Highway, Salem, MO 65560 2019-01-25
1174959142 Britney Nicole Christesen Chiropractor 909 S Pershing Ave, Salem, MO 65560 2013-09-22
1245550474 Amber Nicole Duncan Chiropractor 803 W 32 Hwy, Suite B, Salem, MO 65560 2010-06-10
1043460371 Tina Marie Mcmullin Counselor 601 East Center Street, Salem, MO 65560 2008-09-23
1225286347 Craig Tatom Nurse Practitioner Hwy 72 N Physicians Office Building II, Salem, MO 65560 2008-09-03
1114190576 Jamie Johnston Wilson Registered Nurse Hwy 72 West, Salem, MO 65560 2008-04-08
1750589024 Vicky L Gulley Emergency Medicine 35629 Hwy 72, Pob 1, Suite 3, Salem, MO 65560 2007-07-06
1275669533 Complete Care, Inc Durable Medical Equipment & Medical Supplies 116 W. 4th, Salem, MO 65560 2007-02-23
1023083722 Brent K. Caudill General Practice Hwy 72 N, Salem, MO 65560 2006-02-17
1750369369 Charles W Cunningham Family Medicine 1010 E Scenic Rivers Blvd, Salem, MO 65560 2006-01-04
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Taxonomy Information

Taxonomy Code 363LF0000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Family

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1285247908 Tracy Jean Payton Nurse Practitioner 3898 Lee Road 250, Salem, AL 36874-1450 2020-08-24
1437775137 Krista Michelle Brinkerhoff Nurse Practitioner 636 N 220 E, Salem, UT 84653-5553 2020-06-18
1851913271 Rossiel Pita-roman Nurse Practitioner 25 Oak Ridge Ave Apt 10, Salem, NH 03079-4480 2020-05-07
1487292157 Kelly Daily Morris Nurse Practitioner 5915 Port Stewart Ct Se, Salem, OR 97306-9034 2019-12-12
1174087985 Brenda Gott Nurse Practitioner 3103 Hh Highway, Salem, MO 65560 2019-01-25
1992277594 Shelisa Rena Taylor Nurse Practitioner 1126 Lee Road 250, Salem, AL 36874-1373 2018-12-19
1811472426 Kathryn B Powell Nurse Practitioner 400 Highland Ave Ste 1, Salem, MA 01970-1783 2018-09-28
1609367077 Jennifer Turner Nurse Practitioner 225 Sunbridge Drive, Salem, WV 26426 2018-05-22
1174042535 Elizabeth Keane Nurse Practitioner 9 Riverbank Rd, Salem, MA 01970-5311 2017-09-15
1346766292 Scott Adam Pasquale Nurse Practitioner 331r Highland Ave, Salem, MA 01970-1738 2017-08-22
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Competitor

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City SALEM
Zip Code 65560

Improve Information

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Dataset Information

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.

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