Provider Demographics
NPI:1972917342
Name:YOON, JESSICA HAEUN (PHARMD)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:HAEUN
Last Name:YOON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:735 VINCA CT
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30005-8763
Mailing Address - Country:US
Mailing Address - Phone:404-916-4267
Mailing Address - Fax:
Practice Address - Street 1:10820 ABBOTTS BRIDGE RD
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30097-5793
Practice Address - Country:US
Practice Address - Phone:770-814-8919
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-13
Last Update Date:2014-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH027450183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist