Individual
RAE KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
44045 RIVERSIDE PKWY, LEESBURG, VA 20176-5101
(703) 858-6000
Mailing address
2417 LIBERTY LOOP, HERNDON, VA 20171-5416
(443) 765-0417
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R211952
MD
Other
Enumeration date
09/02/2022
Last updated
09/02/2022
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