Provider Demographics
NPI:1154098978
Name:PARKS, ANA JULIA HUPPI (RN)
Entity Type:Individual
Prefix:
First Name:ANA JULIA
Middle Name:HUPPI
Last Name:PARKS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2612 ERWIN RD UNIT 2309
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-4090
Mailing Address - Country:US
Mailing Address - Phone:202-386-8366
Mailing Address - Fax:
Practice Address - Street 1:2612 ERWIN RD UNIT 2309
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-4090
Practice Address - Country:US
Practice Address - Phone:202-386-8366
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-28
Last Update Date:2021-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN1041599163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse