IndividualActive
Antanisha Parks
NPI 1083556427 · Surgical Physician Assistant · Saint Louis, MO
Provider details
- NPI number
- 1083556427
- Entity type
- Individual
- Primary specialty
- Surgical Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Sex
- Female
- Sole proprietor
- No
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
- Physician Assistant363A00000X
Physician Assistants & Advanced Practice Nursing Providers
Practice location
915 N Grand Blvd
Saint Louis, MO 63106-1621
Phone: (314) 652-4100
Approximate (ZIP-level) locationGet directions
Mailing address
3502 Green Bay Rd Apt 207
North Chicago, IL 60064-3616
Registry dates
- Enumerated
- 2026-04-06
- Last updated
- 2026-04-06
- Certified
- 2026-04-05
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.