Individual
SI AE SUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
6325 HOSPITAL PKWY, JOHNS CREEK, GA 30097-5775
(678) 474-7000
Mailing address
620 SWEET STREAM TRCE, JOHNS CREEK, GA 30097-7154
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN190340
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RN190340
GEORGIA BOARD OF NURSING
GA
Enumeration date
08/02/2021
Last updated
08/02/2021
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