Provider Demographics
NPI:1689746133
Name:PARKER, VALARIE JEAN (APRN)
Entity type:Individual
Prefix:MRS
First Name:VALARIE
Middle Name:JEAN
Last Name:PARKER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 776351
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-6351
Mailing Address - Country:US
Mailing Address - Phone:502-599-9378
Mailing Address - Fax:502-272-5339
Practice Address - Street 1:15600 TURNER DR
Practice Address - Street 2:
Practice Address - City:CRITTENDEN
Practice Address - State:KY
Practice Address - Zip Code:41030-9001
Practice Address - Country:US
Practice Address - Phone:859-356-3172
Practice Address - Fax:502-583-8001
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28170235A363LA2100X
KY3005657363LA2100X
IN71002330A363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN196290198OtherMEDICARE
KY7100254600Medicaid
IN200845160Medicaid
KYK100764OtherMEDICARE
KY7100254600Medicaid