Provider Demographics
NPI:1184965188
Name:PARK, HYEON HUI (APRN, FNP-BC)
Entity type:Individual
Prefix:
First Name:HYEON HUI
Middle Name:
Last Name:PARK
Suffix:
Gender:F
Credentials:APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4310 JOHNS CREEK PKWY STE 180
Mailing Address - Street 2:
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-6090
Mailing Address - Country:US
Mailing Address - Phone:678-957-8908
Mailing Address - Fax:678-854-8008
Practice Address - Street 1:4310 JOHNS CREEK PKWY STE 180
Practice Address - Street 2:
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-6090
Practice Address - Country:US
Practice Address - Phone:678-957-8908
Practice Address - Fax:678-854-8008
Is Sole Proprietor?:No
Enumeration Date:2013-03-15
Last Update Date:2021-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP123556363LF0000X
GARN237528363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily