MEDICARE: TAMARA RENEE KING APRN, FNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	APRN11010144	FL

General Provider Information

NPI Number	:	1033622287
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAMARA RENEE KING APRN, FNP-BC

Provider Business Mailing Address
First Line	:	1522 WESTERN AVE STE 24105
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98101-1522
Country	:	US
Telephone Number	:	702-769-2444
Fax Number	:

Provider Business Practice Location Address
First Line	:	5283 HAWKESBURY WAY
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34119-9582
Country	:	US
Telephone Number	:	702-769-2444
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/09/2017
Last Update Date	:	04/08/2026

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