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General NPI Number Information
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NPI Number | 1134057979
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Entity Type | Individual
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Provider Name | ALICIA KING
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Gender | Female
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Dates
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Enumeration Date | 05/12/2026
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Last Update Date | 05/12/2026
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Provider Practice Location Address
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Address Line | 101 CABARRUS AVE E STE 200
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City | CONCORD
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State | NC
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Zip | 28025-3781
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Country | US
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Telephone | 888-849-7379
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Fax |
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Provider Business Mailing Address
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Address Line | 2839 MOZART WAY
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City | INDIANAPOLIS
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State | IN
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Zip | 46239-6928
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Country | US
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Telephone |
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 28240421C
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License Number State | IN
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