Individual
LANA EUN-CHO KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
7602 BELAIR RD, BALTIMORE, MD 21236-4088
(410) 663-8100
Mailing address
7602 BELAIR RD, BALTIMORE, MD 21236-4088
(410) 663-8100
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
R203799
MD
363LP2300X
Primary Care Nurse Practitioner
R203799
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R203799
STATE LICENSE
MD
Enumeration date
08/06/2014
Last updated
03/26/2018
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