Healthcare Provider Details

I. General information

NPI: 1528589777
Provider Name (Legal Business Name): SEAN HYUM-SUNG PLANK MSN, APRN-RX, FNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2017
Last Update Date: 02/06/2023
Certification Date: 02/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1944 ALLEN CT STE A
JUNEAU AK
99801-9598
US

IV. Provider business mailing address

3406 GLACIER HWY
JUNEAU AK
99801-7251
US

V. Phone/Fax

Practice location:
  • Phone: 907-463-6882
  • Fax:
Mailing address:
  • Phone: 907-463-3303
  • Fax: 907-463-6858

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95006484
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN-2332
License Number StateHI
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number202358
License Number StateAK
# 4
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number823188
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: