Provider Demographics
NPI:1730697921
Name:KIM, YOONIE (APN)
Entity type:Individual
Prefix:
First Name:YOONIE
Middle Name:
Last Name:KIM
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3150 US HIGHWAY 22
Mailing Address - Street 2:
Mailing Address - City:BRANCHBURG
Mailing Address - State:NJ
Mailing Address - Zip Code:08876-3595
Mailing Address - Country:US
Mailing Address - Phone:908-552-0996
Mailing Address - Fax:
Practice Address - Street 1:3150 US HIGHWAY 22
Practice Address - Street 2:
Practice Address - City:BRANCHBURG
Practice Address - State:NJ
Practice Address - Zip Code:08876-3595
Practice Address - Country:US
Practice Address - Phone:908-552-0996
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-22
Last Update Date:2021-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00771700363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner