Individual
JINHEE PARK KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7300 FETTLER PARK DRIVE, DUMFRIES, VA 22025-2050
(703) 447-7500
(703) 441-7692
Mailing address
7300 FETTLER PARK DRIVE, DUMFRIES, VA 22025-2050
(703) 441-7500
(703) 441-7692
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
SP017382
PA
363LP2300X
Primary Care Nurse Practitioner
Primary
0024185744
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103469933
—
PA
Enumeration date
05/11/2017
Last updated
04/29/2025
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