Healthcare Provider Details

I. General information

NPI: 1396600714
Provider Name (Legal Business Name): MARIE KING
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/18/2025
Last Update Date: 01/06/2026
Certification Date: 01/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16582 STATE HIGHWAY 51
DUDLEY MO
63936-8191
US

IV. Provider business mailing address

16582 STATE HIGHWAY 51
DUDLEY MO
63936-8191
US

V. Phone/Fax

Practice location:
  • Phone: 251-403-9856
  • Fax:
Mailing address:
  • Phone: 251-403-9856
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175M00000X
TaxonomyLay Midwife
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: