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1609287267
JISUNG PARK
JACKSON, MS
NPI
1609287267
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: MS R896636)
Enumeration Date
2014-05-16
Last Update Date
2014-08-21
Business Address
-- JISUNG PARK MSN
2500 N STATE ST
JACKSON, MS 39216-4500
Phone number: 601-984-6426
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Mailing Address
-- JISUNG PARK MSN
2500 N STATE ST
JACKSON, MS 39216-4500
Phone number: 601-984-6426
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