Active NPIIndividual providerSole proprietor

Chrisselle Kim, AGNP-C

Nurse Practitioner, Gerontology in Englewood, New Jersey

NPI Number1477336998
Practice location
350 Engle St Fl 6, Englewood, NJ 07631-1808
Fax
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Last updated
May 23, 2024

Chrisselle Kim is a Nurse Practitioner, Gerontology based in Englewood, NJ. Chrisselle Kim practices in Englewood, NJ and has the professional credentials of AGNP-C. The NPI Number for Chrisselle Kim is 1477336998 and holds a License No. 26NJ14901100 (NJ). The current practice location address for Chrisselle Kim is 350 Engle St Fl 6, Englewood, NJ 07631-1808 and can be reached out via phone at 201-568-5250.

Provider Profile Details

NPI Number
1477336998
Provider Name
Chrisselle Kim
Credential
AGNP-C
Provider Entity Type
Individual
Gender
Female
Address
350 Engle St Fl 6, Englewood, NJ 07631-1808
Phone Number
201-568-5250
Primary Taxonomy
Nurse Practitioner, Gerontology · 363LG0600X
Sole Proprietor
Yes
Provider Enumeration Date
August 17, 2023
Last Update Date
May 23, 2024
Certification Date
May 23, 2024
NPI Status
Active

Provider Business Practice Location Address Details

Address
350 Engle St Fl 6
Englewood, NJ 07631-1808
Zip
07631-1808
Phone Number
201-568-5250
Englewood, NJ 07631Get directions →

Provider Business Mailing Address Details

Address
428B 10TH St
Palisades Park, NJ 07650-2323
City
Palisades Park
State
NJ
Zip
07650-2323
Phone Number
917-969-0347
Fax Number
201-568-5358

License Information

License Number
26NJ14901100
License State
NJ
Taxonomy
Nurse Practitioner, Gerontology · 363LG0600X · Primary

Legacy Identifiers

IdentifierTypeStateIssuer
No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider.

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Frequently Asked Questions

What is the NPI number of Chrisselle Kim, AGNP-C?

The NPI number of Chrisselle Kim, AGNP-C is 1477336998. It was assigned on August 17, 2023 and is currently active in the NPPES registry.

What is the specialty of Chrisselle Kim, AGNP-C?

Chrisselle Kim, AGNP-C is registered under the primary taxonomy Nurse Practitioner, Gerontology (code 363LG0600X), licensed in NJ under license number 26NJ14901100.

Where does Chrisselle Kim, AGNP-C practice?

The practice location is 350 Engle St Fl 6, Englewood, NJ 07631-1808. The office can be reached at 201-568-5250 (phone).

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.

How do I verify this NPI record?

This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1477336998 directly on the NPPES registry website.

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