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GLENDA MARIE KING APRN

Acute Care >> Nurse Practitioner >> Physician Assistants & Advanced Practice Nursing Providers

Registrant NPI Number: 1740664226

Individual Registrant:
 GLENDA MARIE KING APRN
Gender: F
Not Sole Proprietor

Location and contact information for practice:
128 DANIEL AVENUE  BOONEVILLE, AR 72927-6502 US
Tel: 479-675-2455  Fax: --

Contact information for business:
128 DANIEL AVENUE  BOONEVILLE, AR 72927-6502 US
Tel: 479-675-2455  Fax: --

Registration Information:
NPI: 1740664226
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
N363LA2100XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Practitioner
Acute Care
ARA004464
Y363LF0000XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Practitioner
ARA004464

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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