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General NPI Number Information
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NPI Number | 1487547063
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Entity Type | Organization
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Legal Business Name | INDEA B KING NURSE PRACTITIONER IN FAMILY HEALTH PLLC
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Dates
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Enumeration Date | 06/02/2025
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Last Update Date | 06/02/2025
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Provider Practice Location Address
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Address Line | 3610 MAIN ST
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City | AMHERST
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State | NY
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Zip | 14226-3123
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Country | US
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Telephone | 716-815-4100
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Fax | 716-217-5480
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Provider Business Mailing Address
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Address Line | 3610 MAIN ST
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City | AMHERST
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State | NY
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Zip | 14226-3123
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Country | US
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Telephone | 716-815-4100
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | INDEA KING
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Credential | FNP-BC
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Telephone | 716-578-6598
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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