Provider Demographics
NPI:1801486246
Name:PARKZES, RUBY (CNP)
Entity type:Individual
Prefix:
First Name:RUBY
Middle Name:
Last Name:PARKZES
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7801 OLD BRANCH AVE STE 411
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:MD
Mailing Address - Zip Code:20735-1608
Mailing Address - Country:US
Mailing Address - Phone:301-835-2683
Mailing Address - Fax:301-235-1625
Practice Address - Street 1:7801 OLD BRANCH AVE STE 411
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:MD
Practice Address - Zip Code:20735-1608
Practice Address - Country:US
Practice Address - Phone:301-835-2683
Practice Address - Fax:301-235-1625
Is Sole Proprietor?:No
Enumeration Date:2021-01-20
Last Update Date:2022-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024180747363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health