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STACEY KING NP
>> Nurse Practitioner >> Physician Assistants & Advanced Practice Nursing ProvidersRegistrant NPI Number: 1598146631
Individual Registrant: STACEY KING NP
Gender: F
Not Sole Proprietor
Gender: F
Not Sole Proprietor
Location and contact information for practice:
21141 STATE HIGHWAY 59 STE 1 ROBERTSDALE, AL 36567-6740 US
Tel: 251-424-1160 Fax: 251-424-1161
Tel: 251-424-1160 Fax: 251-424-1161
Contact information for business:
21141 STATE HIGHWAY 59 STE 1 ROBERTSDALE, AL 36567-6740 US
Tel: 251-424-1160 Fax: 251-424-1161
Tel: 251-424-1160 Fax: 251-424-1161
Registration Information:
NPI: 1598146631
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 363L00000X | Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner | AL | 1-103735 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| 207558 | AL | 05 |
