Provider Demographics
NPI:1114755410
Name:HONG, SUKRAN (FNP-BC)
Entity type:Individual
Prefix:
First Name:SUKRAN
Middle Name:
Last Name:HONG
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:SUK
Other - Middle Name:RAN
Other - Last Name:HONG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:8821 S 40TH DR
Mailing Address - Street 2:
Mailing Address - City:LAVEEN
Mailing Address - State:AZ
Mailing Address - Zip Code:85339-7809
Mailing Address - Country:US
Mailing Address - Phone:480-231-7778
Mailing Address - Fax:
Practice Address - Street 1:8821 S 40TH DR
Practice Address - Street 2:
Practice Address - City:LAVEEN
Practice Address - State:AZ
Practice Address - Zip Code:85339-7809
Practice Address - Country:US
Practice Address - Phone:480-231-7778
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-26
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ311951363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily