Provider Demographics
NPI:1588340491
Name:KIM, NA YON
Entity type:Individual
Prefix:
First Name:NA
Middle Name:YON
Last Name:KIM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:NAYON
Other - Middle Name:
Other - Last Name:KIM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4065 CANE RIDGE PKWY #433
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:TN
Mailing Address - Zip Code:37013
Mailing Address - Country:US
Mailing Address - Phone:615-818-4169
Mailing Address - Fax:
Practice Address - Street 1:4065 CANE RIDGE PKWY #433
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:TN
Practice Address - Zip Code:37013
Practice Address - Country:US
Practice Address - Phone:615-818-4169
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-26
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN472861835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist