Provider Demographics
NPI:1538887971
Name:JOHNG, CHUL HEE JUSTIN (FNP-BC)
Entity type:Individual
Prefix:MR
First Name:CHUL HEE
Middle Name:JUSTIN
Last Name:JOHNG
Suffix:
Gender:M
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9106 W 97TH ST
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66212-5041
Mailing Address - Country:US
Mailing Address - Phone:281-413-2755
Mailing Address - Fax:
Practice Address - Street 1:6830 ANDERSON ST
Practice Address - Street 2:
Practice Address - City:SHAWNEE
Practice Address - State:KS
Practice Address - Zip Code:66226-3101
Practice Address - Country:US
Practice Address - Phone:816-922-2750
Practice Address - Fax:816-922-3399
Is Sole Proprietor?:No
Enumeration Date:2022-08-22
Last Update Date:2023-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH089401-23363LA2200X
KS129041163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163W00000XNursing Service ProvidersRegistered Nurse