| Organization Name: | LILLIAN DAVENPORT PARKER |
| NPI Number: | 1336298264 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | LILLIAN GRACE PARKER (CLINICAL NURSE SPECIALIST) |
| Mailing Address: | 3629 Windmill Rd Ellenwood |
| State: | GA US |
| Postal Code: | 302942106 |
| Phone Number: | 7709871881 |
| Fax Number: | |
| NPI Enumeration Date: | 01/09/2007 |
| NPI Last Update Date: | 06/20/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 364SP0807X |
| License Number: | RN052630 CNSPMH |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Clinical Nurse Specialist |
| Taxonomy Specialization: | Psych/Mental Health, Child & Adolescent |
| Taxonomy Definition: | |