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Contact Information

JIYOUNG CHAE
253 SAGAMORE PKWY W
WEST LAFAYETTE, IN47906-1501
 Phone: 765-448-8000
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Primary Care

363LP2300X 50 Nurse Practitioner
 

Registered Nurse

163W00000X
Indicates primary specialty

NPI Profile & details for JIYOUNG CHAE · (Female)

NPI # 1568845295
Status Active
Credentials
Entity Individual
Enumeration date 06/30/2015
Last updated 09/06/2017 - About 9 years ago
Sole proprietor 1 No
Identifiers
  • IN License # 28193970A
  • IN License # 71005808A
  • IN Medicaid 201323610
  • IN Other 000000964485 ANTHEM PROVIDER PIN NUMBER
Hospital affiliation(s)
  • BLOUNT MEMORIAL HOSPITAL - (Acute Care)
    907 E LAMAR ALEXANDER PARKWAY
    MARYVILLE, TN 37804
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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