Individual
CHRIS KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
9043 W OLIVE AVE, PEORIA, AZ 85345-7049
(623) 776-2065
Mailing address
81 W GUADALUPE RD, GILBERT, AZ 85233-3321
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP10540
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
341238
—
AZ
Enumeration date
08/28/2017
Last updated
11/15/2018
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