Healthcare Provider Details

I. General information

NPI: 1841114626
Provider Name (Legal Business Name): KRISTINA MAY KIM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 W CAMPUS DR
ORANGE CT
06477-3646
US

IV. Provider business mailing address

180 EDWARDS ST APT 1L
NEW HAVEN CT
06511-3740
US

V. Phone/Fax

Practice location:
  • Phone: 203-785-6437
  • Fax:
Mailing address:
  • Phone: 919-619-8810
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: