Individual
KYONGSOOK KIM
Active
Individual
KYONGSOOK KIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
R151075
MD
363LG0600X
Gerontology Nurse Practitioner
Primary
RN962194
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
018733100
—
DC
01
—
N54833
CDS
MD
01
—
R151075
DON
MD
Enumeration date
02/03/2006
Last updated
04/08/2023
Update your record
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