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General NPI Number Information
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NPI Number | 1992229892
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Entity Type | Individual
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Provider Name | ANETRIAL G. KING FNP-C
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Gender | Female
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Dates
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Enumeration Date | 08/01/2017
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Last Update Date | 04/29/2019
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Provider Practice Location Address
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Address Line | 228 SELMA AVE
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City | SELMA
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State | AL
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Zip | 36701-5825
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Country | US
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Telephone | 334-877-1490
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Fax | 334-877-1491
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Provider Business Mailing Address
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Address Line | 2017 ARLINGTON DR
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City | SELMA
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State | AL
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Zip | 36701-7102
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Country | US
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Telephone | 334-327-2442
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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 | F08170065
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License Number State | AL
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