Provider Demographics
NPI:1033794425
Name:SUN, EUNICE EUNJIN (CRNP)
Entity Type:Individual
Prefix:
First Name:EUNICE
Middle Name:EUNJIN
Last Name:SUN
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2601 BLAIR MILL RD APT C22
Mailing Address - Street 2:
Mailing Address - City:WILLOW GROVE
Mailing Address - State:PA
Mailing Address - Zip Code:19090-1120
Mailing Address - Country:US
Mailing Address - Phone:267-261-8214
Mailing Address - Fax:
Practice Address - Street 1:6787 MARKET ST STE 101
Practice Address - Street 2:
Practice Address - City:UPPER DARBY
Practice Address - State:PA
Practice Address - Zip Code:19082-1848
Practice Address - Country:US
Practice Address - Phone:610-352-8000
Practice Address - Fax:610-886-4155
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-16
Last Update Date:2021-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP023463363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily