JEE SON PARK PMHNP-BC NPI 1639840788

NPI Information

NPI: 1639840788
Provider Name: JEE SON PARK, PMHNP-BC
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Individual

Specialization: Psychiatric/Mental Health

Address:
3554 CHAIN BRIDGE RD STE 200
FAIRFAX, VA
ZIP 22030
Phone: (703) 896-7628
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Jee Son Park, PMHNP-BC is a psychiatric/mental health nurse practitioner in Fairfax, VA. Jee Son Park, PMHNP-BC NPI is 1639840788. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

3554 CHAIN BRIDGE RD STE 200
FAIRFAX, VA
ZIP 22030-709
Phone: (703) 896-7628
Fax: (703) 890-2359

The enumeration date for this NPI number is 9/27/2021 and was last updated on 9/27/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	0024182788	VIRGINIA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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