Individual
JEANIE KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
68 BRITTANY CIR, ROCHESTER, NY 14618-5632
(703) 344-5555
Mailing address
68 BRITTANY CIR, ROCHESTER, NY 14618-5632
(703) 344-5555
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
301924
NY
Other
Enumeration date
07/20/2012
Last updated
07/20/2012
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