Healthcare Provider Details

I. General information

NPI: 1093643207
Provider Name (Legal Business Name): SOTRICIA KING
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/11/2026
Last Update Date: 05/11/2026
Certification Date: 05/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3712 2 1/2 ST NE
COLUMBIA HEIGHTS MN
55421-3724
US

IV. Provider business mailing address

3712 2 1/2 ST NE
COLUMBIA HEIGHTS MN
55421-3724
US

V. Phone/Fax

Practice location:
  • Phone: 763-496-9276
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: