Laura Marie Kim, RN, CPNP, DNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

NP0160 Issued in GU

Practice address

133 Route 3
Dededo, GU 96929-6911

Phone

(671) 645-5500

Fax

(617) 645-5549

NPI assigned

Oct 6, 2016

Last updated

Jun 3, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Certified Pediatric Nurse Practitioner, Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1475712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559520000000",
    "number": "1548710189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 ROTA ST",
            "city": "SANTA RITA",
            "state": "GU",
            "postal_code": "969151421",
            "telephone_number": "671-689-6620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 ROUTE 3",
            "city": "DEDEDO",
            "state": "GU",
            "postal_code": "969296911",
            "telephone_number": "671-645-5500",
            "fax_number": "617-645-5549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "LAURA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "RN, CPNP, DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-06",
        "last_updated": "2019-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "GU",
            "license": "NP0160",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041378417",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GU",
            "license": "RE2194",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ji Yeong Kang, M.D.
• Ann M Keenan, AGNP, CCRN
• Kristin Nicole Killoran, MS, RDN
• Jinyoung Kim
• Kyoungmee Kim, N.P.
• Heesoo Ko, DMD
• Andrea Leanne Araullo Kono, PA-C
• Katherine Erin Kruger, NP
• Samuel Scott Larkin
• Scott Robert Larkin, D.C.

• Pediatric Nurse Practitioner in Dededo, GU
• Providers in Dededo, GU by specialty
• Pediatric Nurse Practitioner in Guam

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.