Provider Demographics
NPI:1982466538
Name:JEONG, JULIE MINGYEONG
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:MINGYEONG
Last Name:JEONG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2101 S MARION ST APT H
Mailing Address - Street 2:
Mailing Address - City:KIRKSVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:63501-4700
Mailing Address - Country:US
Mailing Address - Phone:913-284-4279
Mailing Address - Fax:
Practice Address - Street 1:2101 S MARION ST APT H
Practice Address - Street 2:
Practice Address - City:KIRKSVILLE
Practice Address - State:MO
Practice Address - Zip Code:63501-4700
Practice Address - Country:US
Practice Address - Phone:913-284-4279
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-29
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program