Individual
LY KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3313 PACOLET DR, GREENVILLE, NC 27834-6035
(336) 508-0935
Mailing address
3313 PACOLET DR, GREENVILLE, NC 27834-6035
(336) 508-0935
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
AG02220122
NC
Other
Enumeration date
06/21/2022
Last updated
06/21/2022
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