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General NPI Number Information
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NPI Number | 1164057253
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Entity Type | Individual
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Provider Name | JANE KIM
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Gender | Female
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Dates
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Enumeration Date | 03/09/2020
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Last Update Date | 03/04/2026
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Provider Practice Location Address
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Address Line | 600 PEMBERTON BROWNS MILLS RD
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City | PEMBERTON
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State | NJ
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Zip | 08068-1537
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Country | US
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Telephone | 609-894-1100
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Fax | 609-894-1110
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Provider Business Mailing Address
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Address Line | PO BOX 1309
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City | MARLTON
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State | NJ
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Zip | 08053-6309
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Country | US
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Telephone | 609-567-0200
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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 | 346001
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 26NJ01354500
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License Number State | NJ
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