Provider Demographics
NPI:1386510188
Name:JEON, JUNYOUNG (RN)
Entity type:Individual
Prefix:
First Name:JUNYOUNG
Middle Name:
Last Name:JEON
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 CHAPEL DRIVE
Mailing Address - Street 2:APT 203
Mailing Address - City:LAFAYETTE
Mailing Address - State:IN
Mailing Address - Zip Code:47909
Mailing Address - Country:US
Mailing Address - Phone:765-340-0618
Mailing Address - Fax:
Practice Address - Street 1:320 CHAPEL DRIVE
Practice Address - Street 2:APT 203
Practice Address - City:LAFAYETTE
Practice Address - State:IN
Practice Address - Zip Code:47909
Practice Address - Country:US
Practice Address - Phone:765-340-0618
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-17
Last Update Date:2025-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28291519C163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse