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Individual

KYONGSOOK KIM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
1380 SOUTHERN AVE SE, WASHINGTON, DC 20032-4623
(202) 279-5880
Mailing address
18500 NEW HAMPSHIRE AVE, ASHTON, MD 20861-9788
(240) 330-0999

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
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