Provider Demographics
NPI:1053756874
Name:PARKER-LEACH, MERLITA MAY (FIRST ASSISTANT)
Entity type:Individual
Prefix:
First Name:MERLITA
Middle Name:MAY
Last Name:PARKER-LEACH
Suffix:
Gender:F
Credentials:FIRST ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9034 S SILKWOOD LN
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85756-6119
Mailing Address - Country:US
Mailing Address - Phone:520-241-9755
Mailing Address - Fax:
Practice Address - Street 1:9034 S SILKWOOD LN
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85756-6119
Practice Address - Country:US
Practice Address - Phone:520-241-9755
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-07
Last Update Date:2013-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO138939246ZS0410X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Technologist