MEDICARE: MS. LASHAWNA KATRICE KING C.M.

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	176B00000X	Midwife	F001072	NY

General Provider Information

NPI Number	:	1629261557
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LASHAWNA KATRICE KING C.M.

Provider Business Mailing Address
First Line	:	325 HANCOCK ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11216-2402
Country	:	US
Telephone Number	:	718-930-2731
Fax Number	:	587-200-0330

Provider Business Practice Location Address
First Line	:	325 HANCOCK ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11216-2402
Country	:	US
Telephone Number	:	718-930-2731
Fax Number	:	587-200-0330

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

Provider Enumeration Date	:	08/23/2007
Last Update Date	:	09/15/2022

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