MEDICARE: JEMY F KIM NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	NP11593	CA
2	363L00000X	Nurse Practitioner	1082650	TX

General Provider Information

NPI Number	:	1134296908
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEMY F KIM NP

Provider Business Mailing Address
First Line	:	13740 RESEARCH BLVD STE P2
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78750-1835
Country	:	US
Telephone Number	:	310-710-6799
Fax Number	:

Provider Business Practice Location Address
First Line	:	13740 RESEARCH BLVD STE P2
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78750-1835
Country	:	US
Telephone Number	:	323-672-7988
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/29/2006
Last Update Date	:	01/09/2026

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Directions to “ JEMY F KIM NP” Practice Location

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