Individual
IE RAE KIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
14518 N BARROS CT, CENTREVILLE, VA 20120-1641
(571) 243-2799
Mailing address
14518 N BARROS CT, CENTREVILLE, VA 20120-1641
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
24196169
VA
Other
Enumeration date
01/31/2026
Last updated
01/31/2026
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