Provider Demographics
NPI:1669913216
Name:PARKES, ROSS (AGPCNP)
Entity type:Individual
Prefix:MR
First Name:ROSS
Middle Name:
Last Name:PARKES
Suffix:
Gender:M
Credentials:AGPCNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4807 EATON PL
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22310-2006
Mailing Address - Country:US
Mailing Address - Phone:252-689-9376
Mailing Address - Fax:
Practice Address - Street 1:4807 EATON PL
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22310-2006
Practice Address - Country:US
Practice Address - Phone:252-689-9376
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-15
Last Update Date:2025-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5009362363LP2300X, 363LG0600X
MDAC007838363LG0600X
TXAP143693363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care