Provider Demographics
NPI:1407945579
Name:AN, JEANNA CHUN (RN)
Entity Type:Individual
Prefix:DR
First Name:JEANNA
Middle Name:CHUN
Last Name:AN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MS
Other - First Name:CHONGSOOK
Other - Middle Name:
Other - Last Name:CHUN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:18TH MEDCOM
Mailing Address - Street 2:ATTN: DCCS-QM
Mailing Address - City:APO
Mailing Address - State:AP
Mailing Address - Zip Code:96205-0054
Mailing Address - Country:KR
Mailing Address - Phone:0118227-916-6027
Mailing Address - Fax:0118227-917-8110
Practice Address - Street 1:121ST COMBAT SUPPORT HOPITAL
Practice Address - Street 2:BOX 515
Practice Address - City:APO
Practice Address - State:AP
Practice Address - Zip Code:96205
Practice Address - Country:KR
Practice Address - Phone:0118227-917-3100
Practice Address - Fax:0118227-917-3502
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR 113253 7163WI0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WI0600XNursing Service ProvidersRegistered NurseInfection Control