Healthcare Provider Details

I. General information

NPI: 1477480663
Provider Name (Legal Business Name): KING'S STARLING HEALTH & WELLNESS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 05/22/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

618 NW SAVANNAH CIR
LAKE CITY FL
32055-6880
US

IV. Provider business mailing address

618 NW SAVANNAH CIR
LAKE CITY FL
32055-6880
US

V. Phone/Fax

Practice location:
  • Phone: 386-269-2685
  • Fax: 386-603-6981
Mailing address:
  • Phone: 386-269-2685
  • Fax: 386-603-6981

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MRS. CRYSTAL M STARLING
Title or Position: OWNER/AUTHORIZED OFFICIAL
Credential: APRN, AP
Phone: 386-269-2685