Provider Demographics
NPI:1326117268
Name:CHAE, SUN-MI (PHD, RN, CPNP)
Entity Type:Individual
Prefix:DR
First Name:SUN-MI
Middle Name:
Last Name:CHAE
Suffix:
Gender:F
Credentials:PHD, RN, CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2750 S 38TH ST APT 220
Mailing Address - Street 2:
Mailing Address - City:GRAND FORKS
Mailing Address - State:ND
Mailing Address - Zip Code:58201-5971
Mailing Address - Country:US
Mailing Address - Phone:701-777-4557
Mailing Address - Fax:701-777-4096
Practice Address - Street 1:430 OXFORD ST. STOP 9025
Practice Address - Street 2:COLLEGE OF NURSING ROOM 349
Practice Address - City:GRAND FORKS
Practice Address - State:ND
Practice Address - Zip Code:58202-9025
Practice Address - Country:US
Practice Address - Phone:701-777-4557
Practice Address - Fax:701-777-4096
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDR31512363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics