Individual
JENNIFER C LIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4230 BURNHAM AVE, LAS VEGAS, NV 89119
(702) 733-7866
Mailing address
1201 S COLLEGEVILLE RD, COLLEGEVILLE, PA 19426-2998
(702) 733-7866
Taxonomy
Speciality
Code
Description
License number
State
207ZC0500X
Cytopathology Physician
34161
AZ
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
34161
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100512696
—
NV
01
—
12350
MEDICAL LICENSE
NV
01
—
34161
MEDICAL LICENSE
AZ
Enumeration date
06/05/2007
Last updated
08/30/2018
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