| Doctor Name: | KIRK SHIM |
| NPI Number: | 1033491006 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | RN |
| License Number: | RNXXXXX |
| Business Practice Address: | 167 North Main Street Tuba City, AZ - 86045 |
| Business Phone Number: | 9282832501 |
| Business Fax Number: | |
| Mailing Address: | 167 North Main Street, TUBA CITY |
| State: | AZ |
| Postal Code: | 860451302 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 09/15/2011 |
| NPI Last Update Date: | 12/18/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WA2000X |
| License Number: | RNXXXXX |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NV |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Administrator |
| Taxonomy Definition: | |