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General NPI Number Information
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NPI Number | 1033898499
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Entity Type | Individual
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Provider Name | JOSEPH KIM APRN, FNP-C
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Gender | Male
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Dates
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Enumeration Date | 07/13/2023
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Last Update Date | 07/13/2023
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Provider Practice Location Address
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Address Line | 2685 PEACHTREE PKWY
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City | SUWANEE
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State | GA
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Zip | 30024-5646
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Country | US
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Telephone | 770-771-5260
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Fax |
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Provider Business Mailing Address
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Address Line | 259 PRIVET CIR
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City | SUWANEE
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State | GA
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Zip | 30024-7447
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Country | US
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Telephone | 505-331-6509
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN319919
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License Number State | GA
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