Provider Demographics
NPI:1609551605
Name:KIM, NING DEIH
Entity Type:Individual
Prefix:
First Name:NING
Middle Name:DEIH
Last Name:KIM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1510 W 118TH ST S
Mailing Address - Street 2:
Mailing Address - City:JENKS
Mailing Address - State:OK
Mailing Address - Zip Code:74037-4286
Mailing Address - Country:US
Mailing Address - Phone:918-850-6468
Mailing Address - Fax:
Practice Address - Street 1:1510 W 118TH ST S
Practice Address - Street 2:
Practice Address - City:JENKS
Practice Address - State:OK
Practice Address - Zip Code:74037-4286
Practice Address - Country:US
Practice Address - Phone:918-850-6468
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-16
Last Update Date:2023-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist