Healthcare Provider Details

I. General information

NPI: 1992498356
Provider Name (Legal Business Name): MRS. LINDSAY NICHOLE KING
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2023
Last Update Date: 11/13/2025
Certification Date: 11/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3919 TIVERTON RD
RANDALLSTOWN MD
21133-2025
US

IV. Provider business mailing address

3919 TIVERTON RD
RANDALLSTOWN MD
21133-2025
US

V. Phone/Fax

Practice location:
  • Phone: 410-949-5631
  • Fax:
Mailing address:
  • Phone: 410-949-5631
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License Number
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: