Provider Demographics
NPI:1295349058
Name:JANG, JOO YEON (APN-C)
Entity type:Individual
Prefix:
First Name:JOO
Middle Name:YEON
Last Name:JANG
Suffix:
Gender:F
Credentials:APN-C
Other - Prefix:
Other - First Name:JOO
Other - Middle Name:YEON
Other - Last Name:KIM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:388 BROAD AVE
Mailing Address - Street 2:
Mailing Address - City:LEONIA
Mailing Address - State:NJ
Mailing Address - Zip Code:07605-1715
Mailing Address - Country:US
Mailing Address - Phone:201-292-1567
Mailing Address - Fax:
Practice Address - Street 1:388 BROAD AVE
Practice Address - Street 2:
Practice Address - City:LEONIA
Practice Address - State:NJ
Practice Address - Zip Code:07605-1715
Practice Address - Country:US
Practice Address - Phone:201-292-1567
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-31
Last Update Date:2021-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ01049400363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily