Park, Julie

Park, Julie is an individual health care provider with primary practice located at 1860 Town Center Dr Ste 460 , Reston VA 20190-5901. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Park, Julie can be contacted via phone (571) 222-2200.

Contact Information

Primary practice address
1860 Town Center Dr Ste 460 Reston VA 20190-5901
Phone: (571) 222-2200
Fax: (712) 222-2025
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 0024172648 Virginia
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X F335014-1 New York

Profile Details

NPI number 1235320516
LBN Legal business name Park, Julie
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 5th, 2007
Last updated Oct 26th, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1235320516 NPPES
District of Columbia Other 456035ZAN3 MEDICARE PTAN
District of Columbia MEDICAID 1235320516 MEDICARE PTAN

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