Basic Information
| Provider Information | |||||||||
| NPI: | 1922480706 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PARKS | ||||||||
| FirstName: | CHRISTINE | ||||||||
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| Credential: | NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6655 N CANYON CREST DR | ||||||||
| Address2: | 5123 | ||||||||
| City: | TUCSON | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 857500938 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5203313318 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2850 N COUNTRY CLUB RD | ||||||||
| Address2: | |||||||||
| City: | TUCSON | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 857161910 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5203226274 | ||||||||
| FaxNumber: | 5205094496 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/29/2015 | ||||||||
| LastUpdateDate: | 05/06/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 05/06/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | AP7921 | AZ | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.