Individual
MS. JAESOON KATIE CHA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
716 FULLER ST, FORT HUACHUCA, AZ 85613-1624
(520) 533-9113
(520) 533-5148
Mailing address
716 FULLER ST, FORT HUACHUCA, AZ 85613-1624
(520) 533-9113
(520) 533-5148
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
VN221010
CA
Other
Enumeration date
07/18/2016
Last updated
07/18/2016
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