Healthcare Provider Details

I. General information

NPI: 1831748201
Provider Name (Legal Business Name): YOON YOUNG JEONG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2019
Last Update Date: 04/13/2026
Certification Date: 04/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2510 BELLEVUE MEDICAL CENTER DR
BELLEVUE NE
68123-1520
US

IV. Provider business mailing address

2510 BELLEVUE MEDICAL CENTER DR
BELLEVUE NE
68123-1520
US

V. Phone/Fax

Practice location:
  • Phone: 402-595-1156
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number16574
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: