Healthcare Provider Details

I. General information

NPI: 1245184944
Provider Name (Legal Business Name): PARKER FULGHUM PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/21/2026
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2150 PENNSYLVANIA AVE NW
WASHINGTON DC
20037-3201
US

IV. Provider business mailing address

1200 BELLE VISTA DR
ALEXANDRIA VA
22307-2015
US

V. Phone/Fax

Practice location:
  • Phone: 202-741-2210
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA200002569
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: