Provider Demographics
NPI:1881429074
Name:JUNG, RACHEL (FNP-C)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:JUNG
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:670 DEKALB AVE SE UNIT 4529
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30312-1966
Mailing Address - Country:US
Mailing Address - Phone:678-467-6372
Mailing Address - Fax:
Practice Address - Street 1:11758 JONES BRIDGE RD
Practice Address - Street 2:
Practice Address - City:JOHNS CREEK
Practice Address - State:GA
Practice Address - Zip Code:30005-5065
Practice Address - Country:US
Practice Address - Phone:770-772-1830
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-06
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN240186363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily