Jung, Ji Soo Jacquelyn

Jung, Ji Soo Jacquelyn is an sole proprietor health care provider with primary practice located at 401 North Broadway Room 1123, Baltimore MD 21231-2410. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Acute Care, which is considered as her primary health care specialty. Jung, Ji Soo Jacquelyn can be contacted via phone (443) 287-7990.

Contact Information

Primary practice address
401 North Broadway Room 1123 Baltimore MD 21231-2410
Fax: (443) 287-0108
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Acute Care 363LA2100X R131208 Maryland

Profile Details

NPI number 1326203183
LBN Legal business name Jung, Ji Soo Jacquelyn
Credentials CRNP-ACUTE CARE
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 22nd, 2008
Last updated May 8th, 2013 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1326203183 NPPES
Maryland MEDICAID 062820400

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