Provider Demographics
NPI:1356975627
Name:PARKS, JULIE THOMAS (NP-C)
Entity type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:THOMAS
Last Name:PARKS
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:359 QUARTER BRANCH RD
Mailing Address - Street 2:
Mailing Address - City:SUGAR GROVE
Mailing Address - State:VA
Mailing Address - Zip Code:24375-3333
Mailing Address - Country:US
Mailing Address - Phone:276-243-8772
Mailing Address - Fax:
Practice Address - Street 1:1204 N MAIN ST
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:VA
Practice Address - Zip Code:24354-4312
Practice Address - Country:US
Practice Address - Phone:276-783-2511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-26
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024178467363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily