Doctor Name: | NICOLE RENAE KIRBY KING |
NPI Number: | 1184945198 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.D. |
License Number: | 11015672A |
Business Practice Address: | 112 Hospital Ln Suite 200 Danville, IN - 461221977 |
Business Phone Number: | 3177453366 |
Business Fax Number: | |
Mailing Address: | 1100 Southfield Dr, Suite 1370 PLAINFIELD |
State: | IN |
Postal Code: | 461684498 |
Phone Number: | 3178375571 |
Fax Number: | |
NPI Enumeration Date: | 06/14/2010 |
NPI Last Update Date: | 06/24/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | 11015672A |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | IN |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | 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. |