Individual
SO KIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
3002 HIGHWAY K, O FALLON, MO 63368-8675
(866) 389-2727
Mailing address
3002 HIGHWAY K, O FALLON, MO 63368-8675
(866) 389-2727
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2016034713
MO
Other
Enumeration date
09/26/2016
Last updated
12/15/2022
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