Kim, Jisung

Kim, Jisung is an individual health care provider with primary practice located at 3300 Gallows Rd , Falls Church VA 22042-3307. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as her primary health care specialty. Kim, Jisung can be contacted via phone (703) 776-3138.

Contact Information

Primary practice address
3300 Gallows Rd Falls Church VA 22042-3307
Phone: (703) 776-3138
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 0024166745 Virginia

Profile Details

NPI number 1508811852
LBN Legal business name Kim, Jisung
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date May 24th, 2006
Last updated Nov 7th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1508811852 NPPES
Florida Other G3185 BCBS
Florida MEDICAID 304915900 BCBS

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