MEDICARE: ELISABETH 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
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	APRN11045544	FL

General Provider Information

NPI Number	:	1487507455
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELISABETH KING

Provider Business Mailing Address
First Line	:	901 NW 8TH AVE
Second Line	:	STE B8 PMB 1058
City	:	GAINESVILLE
State	:	FL
Zip	:	32601
Country	:	US
Telephone Number	:	352-768-6192
Fax Number	:

Provider Business Practice Location Address
First Line	:	4440 SW ARCHER RD
Second Line	:
City	:	GAINESVILLE
State	:	FL
Zip	:	32608-2255
Country	:	US
Telephone Number	:	352-768-6192
Fax Number	:

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

Provider Enumeration Date	:	02/18/2026
Last Update Date	:	02/18/2026

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Directions to “ ELISABETH KING ” Practice Location

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