Provider Demographics
NPI:1043417645
Name:KANG, HYUN-JU (FNP)
Entity Type:Individual
Prefix:MISS
First Name:HYUN-JU
Middle Name:
Last Name:KANG
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:USAMEDDAC FORT MEADE
Mailing Address - Street 2:2480 LLEWELLYN AVE
Mailing Address - City:FORT MEADE
Mailing Address - State:MD
Mailing Address - Zip Code:20755
Mailing Address - Country:US
Mailing Address - Phone:301-677-8931
Mailing Address - Fax:
Practice Address - Street 1:USAMEDDAC FORT MEADE
Practice Address - Street 2:2480 LLEWELLYN AVE
Practice Address - City:FORT MEADE
Practice Address - State:MD
Practice Address - Zip Code:20755
Practice Address - Country:US
Practice Address - Phone:301-677-8931
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-28
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP116444171000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171000000XOther Service ProvidersMilitary Health Care Provider