Healthcare Provider Details

I. General information

NPI: 1699606582
Provider Name (Legal Business Name): HEE KIM
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2026
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8350 CHICKASAW WAY
PLAIN CITY OH
43064-2633
US

IV. Provider business mailing address

8350 CHICKASAW WAY
PLAIN CITY OH
43064-2633
US

V. Phone/Fax

Practice location:
  • Phone: 614-339-9468
  • Fax:
Mailing address:
  • Phone: 614-339-9468
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberCNP.0042109
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: