Individual
MR. NICHOLAS GENE PARKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
6144 ROLFE AVE, NORFOLK, VA 23508-1026
(757) 339-3876
Mailing address
6144 ROLFE AVE, NORFOLK, VA 23508-1026
(757) 339-3876
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
Primary
0001247709
VA
Other
Enumeration date
09/28/2015
Last updated
09/28/2015
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