Individual
IMSHIN OH KIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
4500 STUART ST, COLUMBIA, SC 29207-5700
(803) 751-2273
Mailing address
1061 HARMON AVE, FORT STEWART, GA 31314-5641
(912) 435-6965
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
500322
NY
363LF0000X
Family Nurse Practitioner
Primary
341727
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/29/2009
Last updated
07/11/2023
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