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NPI Code Detail

MEDICARE: KIM ANN KIM MSN, APRN, PMHNP-BC

MEDICARE: KIM ANN KIM MSN, APRN, PMHNP-BC
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
1363LP0808XPsychiatric/Mental Health Nurse Practitioner16401CT

General Provider Information

NPI Number : 1588340954
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIM ANN KIM MSN, APRN, PMHNP-BC
Provider Business Mailing Address
First Line : 1 HOPE ST
Second Line :
City : BRISTOL
State : CT
Zip : 06010-6374
Country : US
Telephone Number : 860-805-8154
Fax Number :
Provider Business Practice Location Address
First Line : 1 HOPE ST
Second Line :
City : BRISTOL
State : CT
Zip : 06010-6374
Country : US
Telephone Number : 860-805-8154
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/22/2023
Last Update Date : 02/22/2026

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Directions to “ KIM ANN KIM MSN, APRN, PMHNP-BC” Practice Location

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