| Doctor Name: | DR. ANDREA SHANNON PARKER |
| NPI Number: | 1700048790 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.D. |
| License Number: | 11014450A |
| Business Practice Address: | 220 Bellevue Ave Newport, RI - 028403515 |
| Business Phone Number: | 4018490410 |
| Business Fax Number: | |
| Mailing Address: | 40 3rd St, Apt 2 PROVIDENCE |
| State: | RI |
| Postal Code: | 029062727 |
| Phone Number: | 3174171114 |
| Fax Number: | |
| NPI Enumeration Date: | 06/30/2008 |
| NPI Last Update Date: | 07/31/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 390200000X |
| License Number: | 11014450A |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | IN |
| Taxonomy Type: | Student, Health Care |
| Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |