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1154060028
JACQUELINE PHYLLIS PARKS
FORT WAYNE, IN
NPI
1154060028
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
163W00000X Registered Nurse
(Licence: IN 28179527A)
Enumeration Date
2022-05-31
Last Update Date
2022-05-31
Business Address
Mrs. JACQUELINE PHYLLIS PARKS RN
2121 LAKE AVE
FORT WAYNE, IN 46805-5100
Phone number: 260-426-5431
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Mailing Address
Mrs. JACQUELINE PHYLLIS PARKS RN
716 COUNTY ROAD 8
CORUNNA, IN 46730-9756
Phone number: 260-318-1046
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