Individual
JUNE L KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ACNP
Contact information
Practice address
18200 LORAIN AVE # 430, CLEVELAND, OH 44111-5605
(216) 476-7266
Mailing address
18200 LORAIN AVE, CLEVELAND, OH 44111-5605
(216) 476-7606
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
RN-266928
OH
363LA2200X
Adult Health Nurse Practitioner
Primary
022935
OH
363LA2200X
Adult Health Nurse Practitioner
APRN70101-ANP-BC
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000503616
ANTHEM
OH
01
—
209939
UNISON
OH
05
—
2507693
—
OH
05
—
3810013339
—
WV
Enumeration date
07/10/2006
Last updated
07/01/2020
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