| Young Jun Kim, FNP | |
|
804 Landmark Dr Ste 118, Glen Burnie, MD 21061-4486 | |
| (410) 863-4899 | |
| Not Available |
| Full Name | Young Jun Kim |
|---|---|
| Gender | Male |
| Speciality | Nurse Practitioner - Family |
| Location | 804 Landmark Dr Ste 118, Glen Burnie, Maryland |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417732546 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | R233728 (Maryland) | Primary |
| Entity Name | Lifebridge Community Gastroenterology Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1033558416 PECOS PAC ID: 7618108119 Enrollment ID: O20140326001773 |
| Mailing Address | Practice Location Address |
|---|---|
| Young Jun Kim, FNP 8840 Papillon Dr, Ellicott City, MD 21043-4000 Ph: (443) 718-1037 | Young Jun Kim, FNP 804 Landmark Dr Ste 118, Glen Burnie, MD 21061-4486 Ph: (410) 863-4899 |
Ms. Docia Owusu, CRNP-PMH Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 7575 E Howard Rd, Glen Burnie, MD 21060 Phone: 410-768-8200 | |
Mrs. Theresa Eileen Deveaux, CRNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 301 Hospital Dr, Glen Burnie, MD 21061 Phone: 410-553-8300 Fax: 410-553-8349 | |
Ms. Linda Jean Swallow, CRNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 305 Hospital Dr, 1st Floor, Glen Burnie, MD 21061 Phone: 410-552-8154 Fax: 410-553-8134 | |
Mary Bourbon, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1600 S. Cain Highway, Suite 401, Glen Burnie, MD 21061 Phone: 410-768-5050 | |
Christine Marie Habersaat, CPNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1405 Madison Park Dr Ste 1, Glen Burnie, MD 21061 Phone: 410-582-9434 | |
Opemipo Doyin Ogeyingbo, CRNP Nurse Practitioner Medicare: May Accept Medicare Assignments Practice Location: 464 Norvelle Ct, Glen Burnie, MD 21061 Phone: 301-592-7286 | |
Cierra N Vaughters, PMHNP-BC Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 325 Hospital Dr Ste 106, Glen Burnie, MD 21061 Phone: 443-430-2998 |