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NPI Code Detail

MEDICARE: KING'S STARLING HEALTH & WELLNESS, LLC

MEDICARE: KING'S STARLING HEALTH & WELLNESS, LLC
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
1363LP2300XPrimary Care Nurse Practitioner

General Provider Information

NPI Number : 1477480663
Entity Type Code : Organization
Provider Name (Legal Business Name) : KING'S STARLING HEALTH & WELLNESS, LLC
Provider Business Mailing Address
First Line : 618 NW SAVANNAH CIR
Second Line :
City : LAKE CITY
State : FL
Zip : 32055-6880
Country : US
Telephone Number : 386-269-2685
Fax Number : 386-603-6981
Provider Business Practice Location Address
First Line : 618 NW SAVANNAH CIR
Second Line :
City : LAKE CITY
State : FL
Zip : 32055-6880
Country : US
Telephone Number : 386-269-2685
Fax Number : 386-603-6981
Authorized Official
Title or Position : OWNER/AUTHORIZED OFFICIAL
Name : MRS. CRYSTAL M STARLING
Credential : APRN, AP
Telephone Number : 386-269-2685
Provider Enumeration Date : 05/04/2026
Last Update Date : 05/22/2026

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