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General NPI Number Information
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NPI Number | 1609274232
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Entity Type | Individual
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Provider Name | PATRICIA MARIE SOUTH KING DNP-FNP
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Gender | Female
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Dates
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Enumeration Date | 12/13/2014
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Last Update Date | 04/20/2018
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Provider Practice Location Address
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Address Line | 3020 PENINSULA RD APT 641
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City | OXNARD
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State | CA
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Zip | 93035-4075
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Country | US
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Telephone | 901-605-1758
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Fax |
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Provider Business Mailing Address
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Address Line | 3020 PENINSULA RD #641
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City | OXNARD
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State | CA
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Zip | 93035-4059
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Country | US
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Telephone | 901-605-1758
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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 | 23021
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 23021
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License Number State | CA
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