Individual
JIYEON KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2380 CEDAR ST STE 100, HOLT, MI 48842-2210
(517) 742-4900
Mailing address
1270 GARDEN CITY RD APT 455, EAST LANSING, MI 48823-6045
(517) 899-4816
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704383913
MI
Other
Enumeration date
07/09/2022
Last updated
10/30/2025
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