JISUNG PARK MSN
NPI 1609287267
Nurse Practitioner in Jackson, MS

Q: What is Jisung Park's NPI number?

The NPI number for Jisung Park is 1609287267. It was assigned to this individual provider in the NPPES registry on May 16, 2014.

Q: What is Jisung Park's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Q: When was this NPI record last updated?

The NPPES record for Jisung Park was last updated on August 21, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since May 16, 2014

2500 N STATE ST, JACKSON, MS 39216(601) 984-6426(601) 984-6439 Get Directions Write a Review

NPPES record last updated: August 21, 2014. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About Jisung Park Msn NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JISUNG PARK MSN (NPI 1609287267) is an individual nurse practitioner in Jackson, Mississippi, licensed in Mississippi (R896636) and active in the NPI registry since May 2014.

NPPES Registry Identity

NPI1609287267

Entity TypeIndividualFemale

Primary Taxonomy363L00000X

Provider Legal NameJISUNG PARKCredential: MSN

Location Address2500 N STATE STJackson, MS 39216-4500

Mailing Address2500 N State StJackson, MS 39216-4500 · (601) 984-6426 · Fax (601) 984-6439

Phone(601) 984-6426

Fax(601) 984-6439

Sole ProprietorNo

Enumeration DateMay 16, 2014

Last NPPES UpdateAugust 21, 2014

✔ NPI 1609287267 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

License✔ Licensed in MS · R896636

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

2500 N STATE ST, Jackson, MS 39216

Open in Google Maps ↗

Other Identifiers 2

Medicare PIN358915YS8TMS

Medicaid03778200MS

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LAMAR DAVIS II M.D.

Psychiatry & Neurology (Neurology with Special Qualifications in Child Neurology)