Individual
KIBBUM KANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
8640 SUDLEY RD STE 201, MANASSAS, VA 20110-4404
(703) 368-6819
(703) 330-2923
Mailing address
PO BOX 381468, GERMANTOWN, TN 38183-1468
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
0024174551
VA
363LA2200X
Adult Health Nurse Practitioner
Primary
0024174551
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1548502347
—
VA
Enumeration date
03/20/2013
Last updated
02/13/2026
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