Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Min Park, NP

Individual provider Family Nurse Practitioner · NPI 1619826476

Min Park, NP is a Nurse Practitioner in Fairfax, Virginia. Qualified in 2025, 1 year ago. Licensed in Virginia.

Years since qualifying
1
Licensed in
VA
In the registry since
2026
What do these letters mean?
NP — Nurse Practitioner
An advanced practice nurse who can diagnose, treat and in most states prescribe.

See every abbreviation used in this directory →

Practice location Address checks out

11240 Waples Mill Rd Ste 300
Fairfax, VA 22030-6078
Phone: (571) 407-5042
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 0024195870 (VA)

Record details

NPI number1619826476
Entity typeIndividual (Type 1)
GenderMale
Credentials NP
Sole proprietorNo
NPI enumeratedJanuary 26, 2026
Last updated in NPPESJanuary 26, 2026
Certification dateJanuary 26, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Accepts Medicare assignment Not indicated

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