Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 4704243108 | MI |
N | 363LA2200X | Nurse Practitioner - Adult Health | 4704243108 | MI |
NPI | 1023457140 |
---|---|
Provider Name | Hee-Jin B Kim |
First Address | Ann Arbor, MI 48108 |
Second Address | Ann Arbor, MI 48109-5010 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/06/2013 |
Last Update Date | 25/01/2017 |