Individual
CHRISSELLE KIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AGNP-C
Contact information
Practice address
350 ENGLE ST FL 6, ENGLEWOOD, NJ 07631-1808
(201) 568-5250
Mailing address
428B 10TH ST, PALISADES PARK, NJ 07650-2323
(917) 969-0347
(201) 568-5358
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
26NJ14901100
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0981729
—
NJ
Enumeration date
08/17/2023
Last updated
05/23/2024
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