Nicole Soojin Shim
Individual provider Active NPI Pediatric Nurse Practitioner · Cherry Hill, NJ
NPI 1346952140 · NPPES record last updated Feb 16, 2023
Key facts
- NPI
- 1346952140
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatric Nurse Practitioner 363LP0200X
- License
- 26NJ01416400 (NJ)
- Practice address
- 828 Haddonfield Rd
Cherry Hill, NJ 08002-2604 - Phone
- (856) 663-5437
- NPI assigned
- Dec 23, 2022
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26NJ01416400 | NJ | MD | Pediatric Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| PM Pediatrics of Livingston, PLLC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | 26NJ01416400 | NJ | Yes |
Addresses
Primary practice location
828 Haddonfield Rd
Cherry Hill, NJ 08002-2604
Mailing address
828 Haddonfield Rd
Cherry Hill, NJ 08002-2604
Phone (856) 663-5437
Other providers in Cherry Hill, NJ
- Luke Shieh
- Antoinette Shields
- Alan Shienbaum
- Wade D Shiley
- Marlena Shilman
- Serena Shim
- Betty S Shimberg
- Jong T Shin
- Jennifer Shiner
- Punitha Shivaprasad
All providers in Cherry Hill, NJ · Pediatric Nurse Practitioner in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 16, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.