Provider Demographics
NPI:1538638978
Name:VO, KIM (CRNA)
Entity type:Individual
Prefix:
First Name:KIM
Middle Name:
Last Name:VO
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:228 HAMILTON ST
Mailing Address - Street 2:
Mailing Address - City:MERIDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06451-3815
Mailing Address - Country:US
Mailing Address - Phone:203-317-7852
Mailing Address - Fax:
Practice Address - Street 1:228 HAMILTON ST
Practice Address - Street 2:
Practice Address - City:MERIDEN
Practice Address - State:CT
Practice Address - Zip Code:06451-3815
Practice Address - Country:US
Practice Address - Phone:203-317-7852
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-15
Last Update Date:2025-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT111899367500000X
FL11009103367500000X
CT122911367500000X
OR202200283CRNA367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered