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General NPI Number Information
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NPI Number | 1326779489
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Entity Type | Individual
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Provider Name | KRISTI KING HOUSEHOLDER APRN
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Gender | Female
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Dates
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Enumeration Date | 06/20/2022
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Last Update Date | 04/10/2024
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Provider Practice Location Address
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Address Line | 10800 PANAMA CITY BEACH PKWY STE 100
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City | PANAMA CITY BEACH
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State | FL
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Zip | 32407-2532
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Country | US
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Telephone | 850-249-3500
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Fax |
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Provider Business Mailing Address
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Address Line | 249 COUNTY LINE RD
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City | NICEVILLE
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State | FL
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Zip | 32578-8008
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Country | US
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Telephone | 850-401-9355
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 11020460
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 9502446
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License Number State | FL
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