Individual
MRS. JANUARY J KIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
1441 29TH ST STE 305, WEST DES MOINES, IA 50266-1309
(515) 985-2024
(515) 985-2025
Mailing address
1441 29TH ST STE 305, WEST DES MOINES, IA 50266-1309
(515) 985-2024
(515) 985-2025
Taxonomy
Speciality
Code
Description
License number
State
163WP0807X
Child & Adolescent Psychiatric/Mental Health Registered Nurse
083414
IA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
T083414
IA
364SP0809X
Adult Psychiatric/Mental Health Clinical Nurse Specialist
Primary
T083414
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1045898
—
IA
01
—
43845
BLUE SHIELD
IA
01
—
IA0132
JOHN DEERE HC
IA
Enumeration date
03/14/2006
Last updated
06/24/2020
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