Kim, Kyongsook

Kim, Kyongsook is an sole proprietor health care provider with primary practice located at 1380 Southern Ave Se , Washington DC 20032-4623. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Gerontology, which is considered as her primary health care specialty. Kim, Kyongsook can be contacted via phone (202) 279-5880.

Contact Information

Primary practice address
1380 Southern Ave Se Washington DC 20032-4623
Phone: (202) 279-5880
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Gerontology 363LG0600X RN962194 District of Columbia
Physician Assistants & Advanced Practice Nursing Providers / Gerontology 363LG0600X R151075 Maryland

Profile Details

NPI number 1033181060
LBN Legal business name Kim, Kyongsook
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 3rd, 2006
Last updated Apr 8th, 2023 - about 3 years ago

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 1033181060 NPPES
Maryland Other N54833 CDS
Maryland MEDICAID 018733100 CDS
Maryland Other R151075 CDS

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