Provider Demographics
NPI:1417360694
Name:YUN, AZIZA
Entity Type:Individual
Prefix:
First Name:AZIZA
Middle Name:
Last Name:YUN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3555 KELLOGG AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45226-2180
Mailing Address - Country:US
Mailing Address - Phone:513-363-3476
Mailing Address - Fax:513-363-3409
Practice Address - Street 1:3555 KELLOGG AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45226-2180
Practice Address - Country:US
Practice Address - Phone:513-363-3476
Practice Address - Fax:513-363-3409
Is Sole Proprietor?:No
Enumeration Date:2014-06-05
Last Update Date:2023-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0029952363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0100754Medicaid