Individual
KYEONGEUN PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
PO BOX 502415, SAIPAN, MP 96950-2415
(734) 603-0741
Mailing address
PO BOX 502415, SAIPAN, MP 96950-2415
(734) 603-0741
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1002340
MP
Other
Enumeration date
05/04/2026
Last updated
05/04/2026
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