Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LG0600X | Nurse Practitioner - Gerontology | APRNCNP025160 | OH |
NPI | 1023590528 |
---|---|
Provider Name | Sookhee Jeon |
First Address | Cincinnati, OH 45206-1785 |
Second Address | Cincinnati, OH 45219-2364 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2018 |
Last Update Date | 06/02/2020 |