Basic Information
Provider Information
NPI: 1942952064
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PARKS
FirstName: LINDSEY
MiddleName: GRACE
NamePrefix:  
NameSuffix:  
Credential: RN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: UNC-CHAPEL HILL SCHOOL OF NURSING
Address2: 120 N. MEDICAL DR. UNC-CH SON: CARRINGTON HALL
City: CHAPEL HILL
State: NC
PostalCode: 27599
CountryCode: US
TelephoneNumber: 9199664260
FaxNumber:  
Practice Location
Address1: UNC-CHAPEL HILL SCHOOL OF NURSING
Address2: 120 N. MEDICAL DR. UNC-CH SON: CARRINGTON HALL
City: CHAPEL HILL
State: NC
PostalCode: 27599
CountryCode: US
TelephoneNumber: 9199664260
FaxNumber:  
Other Information
ProviderEnumerationDate: 01/20/2022
LastUpdateDate: 01/20/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 01/20/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
390200000X  Y Student, Health CareStudent in an Organized Health Care Education/Training Program 

No ID Information.


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