Provider Demographics
NPI:1619145380
Name:PARKS, MICHELE MCCAY (NP)
Entity type:Individual
Prefix:DR
First Name:MICHELE
Middle Name:MCCAY
Last Name:PARKS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MRS
Other - First Name:MICHELE
Other - Middle Name:MCCAY
Other - Last Name:HUGHES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:13353 SLAYDEN CIRCLE
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:VA
Mailing Address - Zip Code:23005
Mailing Address - Country:US
Mailing Address - Phone:804-387-2907
Mailing Address - Fax:804-764-6141
Practice Address - Street 1:7001 FOREST AVENUE SUITE 405
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23230
Practice Address - Country:US
Practice Address - Phone:804-764-7614
Practice Address - Fax:804-764-6141
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-15
Last Update Date:2024-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA03002363LA2100X
VA0024166117363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care