Individual
SUNG S PARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
811 W 2ND ST, BLOOMINGTON, IN 47403-2251
(812) 333-4001
(812) 333-4053
Mailing address
811 W 2ND ST, BLOOMINGTON, IN 47403-2251
(812) 333-4001
(812) 333-4053
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
71000610
IN
Other
Enumeration date
11/28/2007
Last updated
02/08/2011
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