| Sue Jin Park, RN | |
|
1360 N Main St Ste 124, Bishop, CA 93514-3013 | |
| (760) 873-6533 | |
| (760) 873-3277 |
| Full Name | Sue Jin Park |
|---|---|
| Gender | Female |
| Speciality | Registered Nurse - General Practice |
| Location | 1360 N Main St Ste 124, Bishop, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952813826 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | 95005086 (California) | Secondary |
| 163WG0000X | Registered Nurse - General Practice | 840776 (California) | Primary |
| Entity Name | Northern Inyo Healthcare District |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1922198712 PECOS PAC ID: 8921992090 Enrollment ID: O20040210000652 |
| Mailing Address | Practice Location Address |
|---|---|
| Sue Jin Park, RN 1360 N Main St Ste 124, Bishop, CA 93514-3013 Ph: (760) 873-6533 | Sue Jin Park, RN 1360 N Main St Ste 124, Bishop, CA 93514-3013 Ph: (760) 873-6533 |
Cindy Dixon, Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 162 Grove St Ste J, Bishop, CA 93514 Phone: 760-873-6533 Fax: 760-873-3277 | |
Anita Richardson, RN Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 162 Grove St Ste J, Bishop, CA 93514 Phone: 760-873-6533 Fax: 760-873-3277 | |
Dena Laurice Dondero, RN Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 52 Tu Su Lane, Bishop, CA 93514 Phone: 760-873-8464 Fax: 760-873-3935 | |
Ms. Stephanie Danielle Selke, FNP-C Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 250 N See Vee Lane, Bishop, CA 93514 Phone: 760-873-8461 Fax: 760-873-3935 | |
Michelle Jacqueline Noxsel, NP Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 250 N See Vee Ln, Bishop, CA 93514 Phone: 760-873-8461 Fax: 760-503-4174 | |
Mrs. Connie Lou Connolly, R.N. Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 162 Grove St Ste J, Bishop, CA 93514 Phone: 760-873-6533 | |
Ms. Tina Marie Rodriguez, RN Registered Nurse Medicare: Not Enrolled in Medicare Practice Location: 250 N See Vee Ln, Bishop, CA 93514 Phone: 760-873-7611 Fax: 760-873-3361 |