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NPI Code Detail

MEDICARE: CARRIE MELISSA KING

MEDICARE: CARRIE MELISSA KING
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
1133N00000XNutritionist86297683

General Provider Information

NPI Number : 1073222022
Entity Type Code : Individual
Provider Name (Legal Business Name) : CARRIE MELISSA KING
Provider Business Mailing Address
First Line : 7011 E TOWN LINE RD
Second Line :
City : PICKFORD
State : MI
Zip : 49774-9057
Country : US
Telephone Number : 616-328-1044
Fax Number :
Provider Business Practice Location Address
First Line : 1140 N STATE ST
Second Line :
City : SAINT IGNACE
State : MI
Zip : 49781-1048
Country : US
Telephone Number : 906-643-8585
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/18/2022
Last Update Date : 12/08/2025

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Directions to “ CARRIE MELISSA KING ” Practice Location

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