Provider Demographics
NPI:1942466990
Name:KO, SEONG E (RN)
Entity Type:Individual
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First Name:SEONG
Middle Name:E
Last Name:KO
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Gender:F
Credentials:RN
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Mailing Address - Street 1:15225 SHADY GROVE RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-3254
Mailing Address - Country:US
Mailing Address - Phone:301-987-0020
Mailing Address - Fax:301-987-2420
Practice Address - Street 1:15225 SHADY GROVE RD
Practice Address - Street 2:SUITE 103
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-3254
Practice Address - Country:US
Practice Address - Phone:301-987-0020
Practice Address - Fax:301-987-2420
Is Sole Proprietor?:No
Enumeration Date:2008-07-30
Last Update Date:2016-08-23
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Provider Licenses
StateLicense IDTaxonomies
MDR131012363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner