SU KYUNG KIM CRNP NPI 1073062139

NPI Information

NPI: 1073062139
Provider Name: SU KYUNG KIM, CRNP
Classification: Nurse Practitioner - 363LW0102X
Entity Type: Individual

Specialization: Women's Health

PECOS Registration: Yes

Address:
3400 CIVIC CENTER BLVD
PCAM SOUTH 4TH FLOOR
PHILADELPHIA, PA
ZIP 19104
Phone: (215) 573-6158
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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
1	363LW0102X	Nurse Practitioner	Women's Health	SP013890	PENNSYLVANIA	Yes

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: 11/14/2023

NPI Synchronization or Removal

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