Provider Demographics
NPI:1730423708
Name:YI, JUNE (NP-C)
Entity type:Individual
Prefix:
First Name:JUNE
Middle Name:
Last Name:YI
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:559 VINCENT ST
Mailing Address - Street 2:ATTN: 21 MDOS/SGOF - FAM HLTH
Mailing Address - City:PETERSON AFB
Mailing Address - State:CO
Mailing Address - Zip Code:80914-1540
Mailing Address - Country:US
Mailing Address - Phone:719-526-2273
Mailing Address - Fax:877-813-1756
Practice Address - Street 1:559 VINCENT ST
Practice Address - Street 2:ATTN: 21 MDOS/SGOF - FAM HLTH
Practice Address - City:PETERSON AFB
Practice Address - State:CO
Practice Address - Zip Code:80914-1540
Practice Address - Country:US
Practice Address - Phone:719-526-2273
Practice Address - Fax:877-813-1756
Is Sole Proprietor?:No
Enumeration Date:2012-11-15
Last Update Date:2020-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS13-95846-072390200000X
KS53-76521363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program