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General NPI Number Information
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NPI Number | 1821455783
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Entity Type | Individual
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Provider Name | EUNJI AN SUNG NP-C
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Gender | Female
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Dates
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Enumeration Date | 01/24/2016
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Last Update Date | 10/29/2024
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Provider Practice Location Address
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Address Line | 1325 SATELLITE BLVD NW STE 1503
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City | SUWANEE
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State | GA
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Zip | 30024-4661
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Country | US
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Telephone | 404-470-0557
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Fax | 770-599-7964
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Provider Business Mailing Address
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Address Line | 2180 SATELLITE BLVD STE 400
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City | DULUTH
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State | GA
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Zip | 30097-4927
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Country | US
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Telephone | 404-480-0557
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN224478
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | RN224478
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License Number State | GA
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