Individual
MRS. LAURA MARIE KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, CPNP, DNP
Contact information
Practice address
133 ROUTE 3, DEDEDO, GU 96929-6911
(671) 645-5500
(617) 645-5549
Mailing address
4 ROTA ST, SANTA RITA, GU 96915-1421
(671) 689-6620
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041378417
IL
163W00000X
Registered Nurse
RE2194
GU
363LP0200X
Pediatric Nurse Practitioner
Primary
NP0160
GU
Other
Enumeration date
10/06/2016
Last updated
06/03/2019
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