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General NPI Number Information
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NPI Number | 1477933034
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Entity Type | Individual
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Provider Name | DENISE E KING MSN, RN-BC, CCM
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Gender | Female
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Dates
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Enumeration Date | 06/08/2015
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Last Update Date | 03/22/2024
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Provider Practice Location Address
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Address Line | 6218 N NORMANDY AVE
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City | CHICAGO
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State | IL
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Zip | 60631-2105
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Country | US
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Telephone | 773-806-9056
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Fax |
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Provider Business Mailing Address
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Address Line | 6218 N NORMANDY AVE
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City | CHICAGO
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State | IL
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Zip | 60631-2105
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Country | US
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Telephone | 773-806-9056
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 15570030
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 163WC0400X
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Taxonomy Name | Case Management Registered Nurse
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License Number | 00130579
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 041245195
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License Number State | IL
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