Parks, Carol Lynn

Parks, Carol Lynn is an individual health care provider with primary practice located at 1225 E Coolspring Ave 2-E, Michigan City IN 46360-6312. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Parks, Carol Lynn can be contacted via phone (219) 879-6531.

Contact Information

Primary practice address
1225 E Coolspring Ave 2-E Michigan City IN 46360-6312
Phone: (219) 879-6531
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 71002473A Indiana

Profile Details

NPI number 1013100775
LBN Legal business name Parks, Carol Lynn
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 24th, 2007
Last updated Mar 11th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1013100775 NPPES
Indiana MEDICAID 200923670

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