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General NPI Number Information
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NPI Number | 1407694441
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Entity Type | Individual
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Provider Name | EUN HA SO RN
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Gender | Female
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Dates
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Enumeration Date | 07/15/2024
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Last Update Date | 07/06/2026
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Provider Practice Location Address
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Address Line | 1000 MEDICAL CENTER BLVD
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City | LAWRENCEVILLE
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State | GA
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Zip | 30046-7694
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Country | US
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Telephone | 678-312-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 2735 MCGINNIS FERRY RD UNIT 1525
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City | SUWANEE
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State | GA
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Zip | 30024-5807
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Country | US
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Telephone | 470-399-7697
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 278209
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 158090
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License Number State | GA
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