Most Relevant Information
Provider Data
| NPI Number: | 1003816232 |
| Provider Name: | SUSIE KIM AHN FNP |
| Entity Type: | Individual |
| Taxonomy Code: | 363LF0000X |
| Specialty: | Nurse Practitioner |
| License Number: | 712630 |
Most Important Dates
| Enumeration Date: | 07/29/2005 |
| Last Updated: | 10/19/2023 |
Provider Practice Location
1105 CENTRAL EXPY N STE 2240
ALLEN
TX
750136114
Practice Location Phone/Fax
| Phone: | 8666072308 |
| Fax: |
Provider Mailing Location
PO BOX 570492
DALLAS
TX
753570492
Provider Mailing Phone/Fax
| Phone: | 5627148609 |
| Fax: | 2062023378 |