Individual
JOHN PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
461 21ST AVE S, NASHVILLE, TN 37240-1104
(615) 322-4400
Mailing address
8434 RED EAGLE CT, LORTON, VA 22079-3048
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
AC008499
MD
Other
Enumeration date
06/16/2025
Last updated
01/02/2026
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