Provider Demographics
NPI:1699441014
Name:KIM, EUNYOUNG L (FNP)
Entity type:Individual
Prefix:
First Name:EUNYOUNG
Middle Name:L
Last Name:KIM
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2620 CHESTER AVE AIS CANCER CENTER, 3RD FLOOR
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93301
Mailing Address - Country:US
Mailing Address - Phone:661-337-7175
Mailing Address - Fax:661-337-7194
Practice Address - Street 1:2620 CHESTER AVE
Practice Address - Street 2:AIS CANCER CENTER, 3RD FLOOR
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301
Practice Address - Country:US
Practice Address - Phone:661-337-7175
Practice Address - Fax:661-337-7194
Is Sole Proprietor?:No
Enumeration Date:2021-08-17
Last Update Date:2022-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95018092363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily