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General NPI Number Information
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NPI Number | 1720806326
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Entity Type | Individual
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Provider Name | HOLLY BETH KING PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 10/01/2024
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Last Update Date | 12/23/2024
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Provider Practice Location Address
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Address Line | 2935 KAUFMANN AVE
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City | DUBUQUE
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State | IA
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Zip | 52001-1656
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Country | US
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Telephone | 563-556-0673
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Fax |
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Provider Business Mailing Address
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Address Line | 13 WHEELER CT
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City | SAINT CHARLES
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State | MO
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Zip | 63303-6262
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Country | US
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Telephone | 314-707-9497
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | G182051
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License Number State | IA
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 2024031590
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License Number State | MO
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