Provider Demographics
NPI:1366222788
Name:LUI, KIM ALANE (APN)
Entity type:Individual
Prefix:MRS
First Name:KIM
Middle Name:ALANE
Last Name:LUI
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1061 AVENUE C STE 205
Mailing Address - Street 2:
Mailing Address - City:BAYONNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07002-3328
Mailing Address - Country:US
Mailing Address - Phone:201-843-0800
Mailing Address - Fax:
Practice Address - Street 1:1061 AVENUE C
Practice Address - Street 2:
Practice Address - City:BAYONNE
Practice Address - State:NJ
Practice Address - Zip Code:07002-3328
Practice Address - Country:US
Practice Address - Phone:201-243-0800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-03
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NO10611300163W00000X
NJ26NJ14876400363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No163W00000XNursing Service ProvidersRegistered Nurse