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General NPI Number Information
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NPI Number | 1174251326
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Entity Type | Individual
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Provider Name | MI HWA KIM A-GNP-C
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Gender | Female
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Dates
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Enumeration Date | 08/15/2022
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Last Update Date | 07/31/2023
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Provider Practice Location Address
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Address Line | 4510 MEDICAL CENTER DR. STE. 202
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City | MCKINNEY
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State | TX
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Zip | 75069-3311
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Country | US
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Telephone | 214-272-2774
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Fax |
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Provider Business Mailing Address
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Address Line | 4510 MEDICAL CENTER DR. STE. 202
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City | MCKINNEY
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State | TX
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Zip | 75069
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Country | US
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Telephone | 214-272-2774
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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 | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 1100508
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 1100508
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 865516
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License Number State | TX
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