MEDICARE: MRS. GERILYNNE M JUNG CNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	205036	OH
2	363LA2200X	Adult Health Nurse Practitioner	COA.06877-NP	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1356358626
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. GERILYNNE M JUNG CNP

Provider Business Mailing Address
First Line	:	4900 BABSON PLACE
Second Line	:	SUITE 600
City	:	CINCINNATI
State	:	OH
Zip	:	45272-2636
Country	:	US
Telephone Number	:	513-272-8444
Fax Number	:	513-272-0015

Provider Business Practice Location Address
First Line	:	4900 BABSON PLACE
Second Line	:	SUITE 600
City	:	CINCINNATI
State	:	OH
Zip	:	45272-2636
Country	:	US
Telephone Number	:	513-272-8444
Fax Number	:	513-272-0015

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/01/2006
Last Update Date	:	10/05/2011

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