Basic Information
Provider Information
NPI: 1396122735
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KING
FirstName: NATALIE
MiddleName: C
NamePrefix:  
NameSuffix:  
Credential: NP
OtherOrganizationName:  
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Mailing Information
Address1: 1100 REID PKWY
Address2: MEDICAL STAFF SERVICES
City: RICHMOND
State: IN
PostalCode: 473741157
CountryCode: US
TelephoneNumber: 7659358941
FaxNumber: 7659358578
Practice Location
Address1: 1050 REID PKWY STE 300
Address2: REID ENDOCRINOLOGY CENTER
City: RICHMOND
State: IN
PostalCode: 473741155
CountryCode: US
TelephoneNumber: 7659358941
FaxNumber: 7659358578
Other Information
ProviderEnumerationDate: 05/06/2015
LastUpdateDate: 07/08/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/08/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LA2200X71005726AINY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health

No ID Information.


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