Individual
PAUL JONG-SUN YI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
650 JOEL DR, FORT CAMPBELL, KY 42223-5318
(707) 988-4002
Mailing address
650 JOEL DR, FORT CAMPBELL, KY 42223-5318
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
—
—
363LF0000X
Family Nurse Practitioner
Primary
AP61583942
WA
Other
Enumeration date
04/29/2021
Last updated
08/19/2024
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