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General NPI Number Information
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NPI Number | 1073222022
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Entity Type | Individual
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Provider Name | CARRIE MELISSA KING
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Gender | Female
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Dates
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Enumeration Date | 11/18/2022
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Last Update Date | 12/08/2025
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Provider Practice Location Address
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Address Line | 1140 N STATE ST
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City | SAINT IGNACE
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State | MI
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Zip | 49781-1048
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Country | US
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Telephone | 906-643-8585
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Fax |
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Provider Business Mailing Address
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Address Line | 7011 E TOWN LINE RD
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City | PICKFORD
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State | MI
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Zip | 49774-9057
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Country | US
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Telephone | 616-328-1044
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133N00000X
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Taxonomy Name | Nutritionist
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License Number | 86297683
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License Number State |
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