Individual provider · Type 1 NPI

Jackie Kim

Student in an Organized Health Care Education/Training Program · Beaufort, SC

NPI number 1376427815 Active

Practice location

16 Wando Pl
Beaufort, SC 29906-6041

Call (201) 600-2206 Map

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant 363A00000XNone listed
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1376427815

Jackie Kim's National Provider Identifier is 1376427815, issued on Aug 5, 2025. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Beaufort, SC. The record was last updated on Aug 5, 2025.