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NPI Code Detail

MEDICARE: KIM LOUISE PARKS FNP-BC

MEDICARE: KIM LOUISE PARKS FNP-BC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner0024168364VA

General Provider Information

NPI Number : 1245239763
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIM LOUISE PARKS FNP-BC
Provider Business Mailing Address
First Line : 700 24TH STREET
Second Line :
City : FORT LEE
State : VA
Zip : 23801-1716
Country : US
Telephone Number : 804-734-9993
Fax Number : 804-734-9312
Provider Business Practice Location Address
First Line : 700 24TH STREET
Second Line :
City : FORT LEE
State : VA
Zip : 23801-1716
Country : US
Telephone Number : 804-734-9993
Fax Number : 804-734-9312
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/18/2005
Last Update Date : 03/05/2012

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Directions to “ KIM LOUISE PARKS FNP-BC” Practice Location

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