Healthcare Provider Details

I. General information

NPI: 1265343164
Provider Name (Legal Business Name): CHANEL KING NBC-HWC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/17/2026
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5744 COLTS GATE DR
NEW ALBANY OH
43054-8025
US

IV. Provider business mailing address

5744 COLTS GATE DR
NEW ALBANY OH
43054-8025
US

V. Phone/Fax

Practice location:
  • Phone: 614-800-6057
  • Fax:
Mailing address:
  • Phone: 614-800-6057
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License NumberA-3968769
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: