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General NPI Number Information
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NPI Number | 1578226809
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Entity Type | Individual
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Provider Name | DANIELLE ALYSE KING PA-C
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Gender | Female
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Dates
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Enumeration Date | 10/13/2021
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Last Update Date | 06/18/2024
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Provider Practice Location Address
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Address Line | 28 BLACKWELL PARK LN
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City | WARRENTON
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State | VA
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Zip | 20186-2685
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Country | US
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Telephone | 540-701-4656
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Fax |
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Provider Business Mailing Address
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Address Line | 951 FELL ST APT 330
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City | BALTIMORE
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State | MD
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Zip | 21231-3589
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Country | US
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Telephone | 443-752-6979
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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 | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 0110009164
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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