Provider Demographics
NPI:1831082767
Name:LUNN, KIM MICHELLE (RN)
Entity type:Individual
Prefix:
First Name:KIM
Middle Name:MICHELLE
Last Name:LUNN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2720 BOGOTA AVE
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33026-4511
Mailing Address - Country:US
Mailing Address - Phone:754-779-1841
Mailing Address - Fax:
Practice Address - Street 1:2720 BOGOTA AVE
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33026-4511
Practice Address - Country:US
Practice Address - Phone:754-779-1841
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-30
Last Update Date:2025-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN2900972163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse