Individual
DANIELLE TAEWON UM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN RN APRN AGPCNP-C
Contact information
Practice address
10680 MEDLOCK BRIDGE RD STE 102, JOHNS CREEK, GA 30097-8420
(770) 389-9116
Mailing address
6050 ROSWELL RD APT 219, SANDY SPRINGS, GA 30328-4090
(917) 674-8177
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
743547
NY
163W00000X
Registered Nurse
RN298325
GA
363L00000X
Nurse Practitioner
309735
NY
363L00000X
Nurse Practitioner
Primary
RN298325
GA
Other
Enumeration date
03/25/2020
Last updated
11/23/2020
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