Individual provider · Type 1 NPI
Jeong Mi Pak, APRN
Psychiatric/Mental Health Nurse Practitioner · Farmington, CT
NPI number
1174097331
Active
Practice location
1053 Farmington Ave # 110
Farmington, CT 06032-1574
Fax (860) 808-0040
Mailing address
574 Willis St
Bristol, CT 06010-7267
Other practice locations
- 11-13 Sunflower Ave, Paramus, NJ 07652-3700 · (855) 505-2880
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | 8209 (CT) |
| Family Nurse Practitioner | 363LF0000X | 816263 (NV) |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 26NJ01120900 (NJ) |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 11005195 (FL) |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
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About NPI 1174097331
Jeong Mi Pak, APRN's National Provider Identifier is 1174097331, issued on Jan 21, 2019. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Farmington, CT. The record was last updated on Aug 2, 2026.