Doctor Name: | KRISTI A KING |
NPI Number: | 1104808005 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | NP-C |
License Number: | 71001867A |
Business Practice Address: | 128 N Randolph St Garrett, IN - 467381138 |
Business Phone Number: | 2603576557 |
Business Fax Number: | 2603570373 |
Mailing Address: | Po Box 623, AUBURN |
State: | IN |
Postal Code: | 467060623 |
Phone Number: | 2609278105 |
Fax Number: | 2609278026 |
NPI Enumeration Date: | 11/16/2005 |
NPI Last Update Date: | 04/04/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LC1500X |
License Number: | 71001867A |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | IN |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Community Health |
Taxonomy Definition: |