Individual provider · Type 1 NPI
Kiwon Park, FNP-C
Nurse Practitioner · Fullerton, CA
Practice location
111 W Valencia Dr
Fullerton, CA 92832-2317
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner Primary | 363L00000X | 95036452 (CA) |
Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…
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About NPI 1346124864
Kiwon Park, FNP-C's National Provider Identifier is 1346124864, issued on Aug 5, 2025. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Fullerton, CA. The record was last updated on Aug 7, 2025.