Individual
MRS. LAURA MARIE KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, CPNP, DNP
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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