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:
Health care specialties
| Specialty | Code | License # | 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 4 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1235320516 | NPPES |
| District of Columbia | Other | 456035ZAN3 | MEDICARE PTAN |
| District of Columbia | MEDICAID | 1235320516 | MEDICARE PTAN |
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