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).
| 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 |
| 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 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 18950 Highway C, Lenox, MO 655419306 | 5732470715 |
| Street Address |
35629 HIGHWAY 72 |
| City | SALEM |
| State | MO |
| Zip Code | 65560-7217 |
| 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 |
| Find all providers in the same location | ||||
| 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 |
| Find all providers in zip 65560 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| 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 |
| Find all providers in SALEM | ||||
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| 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.