Parks, Kelly Potter
Parks, Kelly Potter is an individual health care provider with primary practice located at 121 S Front St , Seaford DE 19973-3511. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as her primary health care specialty. Parks, Kelly Potter can be contacted via phone (302) 629-5030.Contact Information
Primary practice address
121 S Front St
Seaford DE 19973-3511
Phone: (302) 629-5030
Fax: (302) 629-5035
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | C5-0000165 | Delaware |
Profile Details
NPI number | 1184746026 |
---|---|
LBN Legal business name | Parks, Kelly Potter |
Credentials | Physician's Assistant Certified (PA-C) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Apr 4th, 2007 |
Last updated | Aug 16th, 2007 - about 17 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1184746026 | NPPES |
Delaware | Other | C5-0000165 | STATE LICENSE NUMBER |
Delaware | Other | RXPA02015 | STATE LICENSE NUMBER |
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