WANDA KING

KINGSPORT, TN
NPI1679958995
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363L00000X Nurse Practitioner
(Licence: NM  CNP-58574)
Additional Taxonomies363L00000X Nurse Practitioner
(Licence: TN  APN20121)
Enumeration Date2015-07-28
Last Update Date2020-01-10
Business Address
WANDA KING
105 W STONE DR STE 4C
KINGSPORT, TN 37660-3365
Phone number: 423-578-1595
Mailing Address
WANDA KING
2539 MEDICAL DR STE 107
ALAMOGORDO, NM 88310-8720
Phone number: 575-446-5940