Provider Demographics
NPI:1619581220
Name:ASH, KIM JUHEE
Entity Type:Individual
Prefix:
First Name:KIM
Middle Name:JUHEE
Last Name:ASH
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 1:1928 E CHARLESTON BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89104-1993
Mailing Address - Country:US
Mailing Address - Phone:702-678-5089
Mailing Address - Fax:702-432-0031
Practice Address - Street 1:1928 E CHARLESTON BLVD STE A
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89104-1993
Practice Address - Country:US
Practice Address - Phone:702-678-5089
Practice Address - Fax:702-432-0031
Is Sole Proprietor?:No
Enumeration Date:2020-09-01
Last Update Date:2020-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant