| NPI | 1568239341 |
|---|---|
| Former Name | KORIE KATHLYNE PARKS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OR 10019170) |
| Enumeration Date | 2023-12-11 |
| Last Update Date | 2023-12-11 |