Healthcare Provider Details

I. General information

NPI: 1508981820
Provider Name (Legal Business Name): BARBARA J KING FNP, BC, CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2007
Last Update Date: 01/08/2024
Certification Date: 01/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8710 MANCHESTER RD
SAINT LOUIS MO
63144-2724
US

IV. Provider business mailing address

PO BOX 639295 DEPT 93394
CINCINNATI OH
45263-9295
US

V. Phone/Fax

Practice location:
  • Phone: 314-961-3570
  • Fax: 314-961-6450
Mailing address:
  • Phone: 248-266-4200
  • Fax: 855-618-6655

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number112038
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberCNP-02719
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: