Provider Demographics
NPI:1679809578
Name:WOO, HAN YI (FNP)
Entity Type:Individual
Prefix:
First Name:HAN
Middle Name:YI
Last Name:WOO
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 1:11050 MT BELVEDERE BLVD
Mailing Address - Street 2:USA MEDDAC
Mailing Address - City:FORT DRUM
Mailing Address - State:NY
Mailing Address - Zip Code:13602-5004
Mailing Address - Country:US
Mailing Address - Phone:315-772-6985
Mailing Address - Fax:315-772-1356
Practice Address - Street 1:11050 MT BELVEDERE BLVD
Practice Address - Street 2:USA MEDDAC
Practice Address - City:FORT DRUM
Practice Address - State:NY
Practice Address - Zip Code:13602-5004
Practice Address - Country:US
Practice Address - Phone:315-772-6985
Practice Address - Fax:315-772-1356
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-27
Last Update Date:2010-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP19306364SF0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SF0001XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistFamily Health