Individual
DEDAN PARKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
59 FORRESTER ST SW APT B, WASHINGTON, DC 20032-2120
(202) 718-9553
Mailing address
59 FORRESTER ST SW APT B, WASHINGTON, DC 20032-2120
(202) 718-9553
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
03120085466
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
90874372
—
DC
Enumeration date
08/06/2019
Last updated
08/06/2019
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