Individual
MRS. MIN JUNG SOPHIA KANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-5815
(601) 984-5842
Mailing address
2500N STATE ST, JMM ROOM 2525, JACKSON, MS 39216-4500
(601) 984-5815
(601) 984-5842
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
R852417
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05024859
—
MS
Enumeration date
08/30/2015
Last updated
08/19/2016
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