Provider Demographics
NPI:1134296908
Name:KIM, JEMY F (NP)
Entity type:Individual
Prefix:
First Name:JEMY
Middle Name:F
Last Name:KIM
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 W HIGHWAY 290 STE B105
Mailing Address - Street 2:
Mailing Address - City:DRIPPING SPRINGS
Mailing Address - State:TX
Mailing Address - Zip Code:78620-4381
Mailing Address - Country:US
Mailing Address - Phone:512-991-5570
Mailing Address - Fax:
Practice Address - Street 1:400 W HIGHWAY 290 STE B105
Practice Address - Street 2:
Practice Address - City:DRIPPING SPRINGS
Practice Address - State:TX
Practice Address - Zip Code:78620-4381
Practice Address - Country:US
Practice Address - Phone:512-991-5570
Practice Address - Fax:512-229-0940
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP11593363L00000X
TX1082650363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner