MEDICARE: EUNYOUNG KIM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WH0200X	Home Health Registered Nurse	RN291397	GA

General Provider Information

NPI Number	:	1417815051
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EUNYOUNG KIM

Provider Business Mailing Address
First Line	:	4751 CREEK HILL LN
Second Line	:
City	:	SUGAR HILL
State	:	GA
Zip	:	30518-7892
Country	:	US
Telephone Number	:	646-829-8534
Fax Number	:

Provider Business Practice Location Address
First Line	:	3655 HOWELL FERRY RD STE 400
Second Line	:
City	:	DULUTH
State	:	GA
Zip	:	30096-3186
Country	:	US
Telephone Number	:	678-506-8822
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/13/2026
Last Update Date	:	01/13/2026

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