Individual
CHARLOTTE ANN PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
115 E FESLER ST, SANTA MARIA, CA 93454-4404
(805) 922-6597
Mailing address
502 BAYWOOD ST, LOMPOC, CA 93437-1328
(801) 960-5488
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0024187554
VA
363LF0000X
Family Nurse Practitioner
Primary
NP95035328
CA
Other
Enumeration date
08/04/2023
Last updated
03/31/2026
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