SU KYUNG KIM CRNP NPI 1073062139

NPI Information

  • NPI: 1073062139
  • Provider Name: SU KYUNG KIM, CRNP
  • Classification: Nurse Practitioner - 363LW0102X
  • Specialization: Women's Health
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 3400 CIVIC CENTER BLVD
    PCAM SOUTH 4TH FLOOR
    PHILADELPHIA, PA
    ZIP 19104
  • Phone: (215) 573-6158

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NPI Details

Su Kyung Kim, CRNP is a women's health nurse practitioner in Philadelphia, PA. Su Kyung Kim, CRNP NPI is 1073062139. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

3400 CIVIC CENTER BLVD
PCAM SOUTH 4TH FLOOR
PHILADELPHIA, PA
ZIP 19104-127
Phone: (215) 573-6158

The NPI 1073062139 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 9/29/2016 and was last updated on 12/1/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LW0102XNurse PractitionerWomen's HealthSP013890PENNSYLVANIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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