MEDICARE: KAREN B KING CNM

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	0024165271	VA

General Provider Information

NPI Number	:	1720059470
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAREN B KING CNM

Provider Business Mailing Address
First Line	:	1625 N GEORGE MASON DR
Second Line	:	SUITE 325
City	:	ARLINGTON
State	:	VA
Zip	:	22205-3683
Country	:	US
Telephone Number	:	703-717-4600
Fax Number	:	703-717-4601

Provider Business Practice Location Address
First Line	:	1625 N GEORGE MASON DR
Second Line	:	SUITE 325
City	:	ARLINGTON
State	:	VA
Zip	:	22205-3683
Country	:	US
Telephone Number	:	703-717-4600
Fax Number	:	703-717-4601

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

Provider Enumeration Date	:	01/31/2006
Last Update Date	:	12/29/2020

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