Provider Demographics
NPI:1750390258
Name:JUNG, EUISHIN (CRNA)
Entity type:Individual
Prefix:
First Name:EUISHIN
Middle Name:
Last Name:JUNG
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:EUISHIN
Other - Middle Name:
Other - Last Name:MURPHY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:200 1ST STREET SW
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55905
Mailing Address - Country:US
Mailing Address - Phone:507-284-2511
Mailing Address - Fax:570-768-3911
Practice Address - Street 1:200 1ST STREET SW
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55905
Practice Address - Country:US
Practice Address - Phone:507-284-2511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2021-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN582184367500000X
MN244780-7367500000X
MN2067367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102381043Medicaid
PA110779Medicare PIN