Individual
JAEKYUNG JACEY CHO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
3283 WILLOWCREEK RD, PORTAGE, IN 46368-5054
(219) 764-8439
(219) 794-8463
Mailing address
PO BOX 781076, DETROIT, MI 48278-1076
(317) 528-4800
(317) 865-1479
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
28258410A
IN
363LF0000X
Family Nurse Practitioner
Primary
71012901A
IN
Other
Enumeration date
08/08/2022
Last updated
04/17/2023
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