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General NPI Number Information
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NPI Number | 1508264292
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Entity Type | Individual
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Provider Name | KRISTIN LYNN KING MSN, AGPCNP-BC
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Gender | Female
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Dates
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Enumeration Date | 12/11/2014
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Last Update Date | 11/18/2016
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Provider Practice Location Address
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Address Line | 230 W MONROE ST SUITE 2540
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City | CHICAGO
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State | IL
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Zip | 60606-4703
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Country | US
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Telephone | 847-313-5982
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Fax |
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Provider Business Mailing Address
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Address Line | 230 W MONROE ST SUITE 2540
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City | CHICAGO
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State | IL
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Zip | 60606-4703
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Country | US
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Telephone | 847-313-5982
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 209011726
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License Number State | IL
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