MEDICARE: JULIA THOMAS PARK NP

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
1	363LX0001X	Obstetrics & Gynecology Nurse Practitioner	APN7739	TN

General Provider Information

NPI Number	:	1780848267
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIA THOMAS PARK NP

Provider Business Mailing Address
First Line	:	5121 MARYLAND WAY STE 215
Second Line	:
City	:	BRENTWOOD
State	:	TN
Zip	:	37027-7516
Country	:	US
Telephone Number	:	615-557-7585
Fax Number	:	615-246-3958

Provider Business Practice Location Address
First Line	:	5121 MARYLAND WAY STE 215
Second Line	:
City	:	BRENTWOOD
State	:	TN
Zip	:	37027-7516
Country	:	US
Telephone Number	:	615-557-7585
Fax Number	:	615-246-3958

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/15/2008
Last Update Date	:	03/14/2025

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