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Individual

JO ANN KIM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN, PHD, CDCES

Contact information

Practice address
222 CREEK DR, LEBANON, PA 17042-8714
(605) 202-1410
Mailing address
222 CREEK DR, LEBANON, PA 17042-8714
(605) 202-1410

Taxonomy

Speciality
Code
Description
License number
State
163WD0400X
Diabetes Educator Registered Nurse
Primary
RN764248
PA

Other

Enumeration date
07/02/2025
Last updated
07/02/2025
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