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Individual

MIN KIM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
8700 SUDLEY RD, MANASSAS, VA 20110-4418
(703) 369-8000
Mailing address
3100 SPRING FOREST RD, STE 130, RALEIGH, NC 27616-2880
(919) 882-7908
(919) 873-9821

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
0001194950
VA
367500000X
Certified Registered Nurse Anesthetist
Primary
0024174797
VA

Other

Enumeration date
11/01/2016
Last updated
05/05/2017
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