Individual ProviderMinhee ParkNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address2008 River Bend Way, Johns Creek, GA 30097-6509(678) 908-5925PECOS EnrollmentBased on the most recent information from CMS, provider Minhee Park does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records today at 9:24 AM.Profile DetailsProvider ID1891647152Provider TypeIndividualFull NamePark, MinheeGenderFemaleSole ProprietorNoEnumeration Date2/10/2026Last Updated2/10/2026Contact InformationPractice LocationPractice Address2008 River Bend Way, Johns Creek, GA 30097-6509Phone(678) 908-5925FaxUnlisted FaxMailing LocationMailing Address2008 River Bend Way, Johns Creek, GA 30097-6509PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363LF0000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicenseAPRN-NP315518Georgia