Individual
JESSICA S KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
041399309
IL
163WE0003X
Emergency Registered Nurse
95236442
CA
363LA2100X
Acute Care Nurse Practitioner
Primary
277003499
IL
363LA2100X
Acute Care Nurse Practitioner
95016336
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
209.021840
DEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATION
IL
Enumeration date
07/14/2020
Last updated
12/05/2024
Update your record
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