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NPI Code Detail

MEDICARE: LAURIE MARHA KING MSN CNP

MEDICARE:   LAURIE MARHA KING  MSN CNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerR0974673MN

General Provider Information

NPI Number : 1841285848
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAURIE MARHA KING MSN CNP
Provider Business Mailing Address
First Line : 9650 HOWARD LAKE DR NE
Second Line :
City : FOREST LAKE
State : MN
Zip : 55025-8430
Country : US
Telephone Number : 651-464-7989
Fax Number :
Provider Business Practice Location Address
First Line : 12900 RIVERDALE DR NW
Second Line :
City : COON RAPIDS
State : MN
Zip : 55448-1063
Country : US
Telephone Number : 612-659-7111
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/15/2005
Last Update Date : 07/08/2007

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Directions to “ LAURIE MARHA KING MSN CNP” Practice Location

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