Provider Demographics
NPI:1679842942
Name:TENG, KIM MCKINNEY (RN)
Entity Type:Individual
Prefix:MS
First Name:KIM
Middle Name:MCKINNEY
Last Name:TENG
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 1:25 HIGH SCHOOL DR
Mailing Address - Street 2:
Mailing Address - City:PENFIELD
Mailing Address - State:NY
Mailing Address - Zip Code:14526-1422
Mailing Address - Country:US
Mailing Address - Phone:585-249-6780
Mailing Address - Fax:585-249-6810
Practice Address - Street 1:25 HIGH SCHOOL DR
Practice Address - Street 2:
Practice Address - City:PENFIELD
Practice Address - State:NY
Practice Address - Zip Code:14526-1422
Practice Address - Country:US
Practice Address - Phone:585-249-6780
Practice Address - Fax:585-249-6810
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-15
Last Update Date:2011-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY405974-1163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool