Basic Information
| Provider Information | |||||||||
| NPI: | 1235519588 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PARKER | ||||||||
| FirstName: | KATHERINE | ||||||||
| MiddleName: | |||||||||
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| Credential: | PHARMD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3336 MONANS RILL CV | ||||||||
| Address2: | |||||||||
| City: | HERNANDO | ||||||||
| State: | MS | ||||||||
| PostalCode: | 386324234 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9014068210 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1640 CENTURY CENTER PKWY | ||||||||
| Address2: | |||||||||
| City: | MEMPHIS | ||||||||
| State: | TN | ||||||||
| PostalCode: | 381348822 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9013853600 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/02/2015 | ||||||||
| LastUpdateDate: | 10/02/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 10/02/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 183700000X | 07332 | MS | N | Pharmacy Service Providers | Pharmacy Technician | 3336L0003X | T-15977 | MS | N | Suppliers | Pharmacy | Long Term Care Pharmacy | 183500000X | 40813 | TN | Y | Pharmacy Service Providers | Pharmacist |
No ID Information.