Individual
YEJIN KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGNP
Contact information
Practice address
4420 LAKE BOONE TRL, RALEIGH, NC 27607-7505
(919) 784-3542
Mailing address
4204 SIX FORKS RD APT 914, RALEIGH, NC 27609-6423
(269) 944-6470
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
312559
NC
363L00000X
Nurse Practitioner
AG06230234
NC
363LA2200X
Adult Health Nurse Practitioner
Primary
5018482
NC
363LG0600X
Gerontology Nurse Practitioner
5018482
NC
Other
Enumeration date
04/12/2023
Last updated
12/18/2023
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