| NPI | 1780854976 |
|---|---|
| Former Name | CAROLYN KING |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: FL 9313355) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL ARNP9313355) |
| 363LF0000X Nurse Practitioner Family (Licence: MO 112790) | |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: MO 112790) | |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: KS 77220) | |
| Enumeration Date | 2008-03-04 |
| Last Update Date | 2023-08-07 |