Individual
JINA PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGPCNP-C
Contact information
Practice address
6363 N STATE HIGHWAY 161 STE 100, IRVING, TX 75038-2239
(469) 200-3272
Mailing address
1601 N BELT LINE RD STE B, MESQUITE, TX 75149-1791
(972) 329-3500
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
810471
TX
363LA2200X
Adult Health Nurse Practitioner
Primary
AP132571
TX
Other
Enumeration date
02/23/2017
Last updated
12/12/2022
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