Provider Demographics
NPI:1669175121
Name:LIM, JOO HYANG (AGPCNP)
Entity type:Individual
Prefix:
First Name:JOO
Middle Name:HYANG
Last Name:LIM
Suffix:
Gender:F
Credentials:AGPCNP
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Mailing Address - Street 1:4488 FOREST PARK AVE STE 160
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63108-2215
Mailing Address - Country:US
Mailing Address - Phone:314-286-1967
Mailing Address - Fax:314-286-1985
Practice Address - Street 1:4488 FOREST PARK AVE STE 160
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63108-2215
Practice Address - Country:US
Practice Address - Phone:314-255-2204
Practice Address - Fax:314-286-1985
Is Sole Proprietor?:No
Enumeration Date:2023-03-23
Last Update Date:2024-06-21
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Provider Licenses
StateLicense IDTaxonomies
MO2022044633363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care