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General NPI Number Information
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NPI Number | 1659355410
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Entity Type | Individual
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Provider Name | KELLY ANN KING MD
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Gender | Female
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Dates
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Enumeration Date | 12/05/2005
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Last Update Date | 02/24/2016
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Provider Practice Location Address
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Address Line | 1835 ODDIE BLVD
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City | SPARKS
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State | NV
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Zip | 89431-3559
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Country | US
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Telephone | 775-982-5140
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Fax | 775-982-5141
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Provider Business Mailing Address
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Address Line | 780 KUENZLI ST STE 202
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City | RENO
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State | NV
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Zip | 89502-0837
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Country | US
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Telephone | 775-982-4590
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Fax | 775-982-4595
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 11634
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 11634
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License Number State | NV
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