Individual
KELLY H. C. KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1708 OLD DONATION PKWY, VIRGINIA BEACH, VA 23454-3064
(757) 395-5300
Mailing address
5700 CLEVELAND ST, SUITE 228, VIRGINIA BEACH, VA 23462-1752
(757) 499-2825
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
0001199919
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001199919
STATE RN LICENSE
VA
Enumeration date
10/19/2006
Last updated
07/08/2007
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