Individual
GLORIA S. KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
4735 OGLETOWN STANTON RD STE 1250, NEWARK, DE 19713
(302) 623-0200
(302) 623-0117
Mailing address
200 HYGEIA DR STE 2300, NEWARK, DE 19713-2049
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
L1-0020432
DE
363LF0000X
Family Nurse Practitioner
Primary
LG-0000396
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
162440
MEDICARE GROUP NUMBER
DE
05
—
1740348986
—
DE
Enumeration date
12/04/2006
Last updated
04/17/2019
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