MEDICARE: BARBARA E KING FNP-BC

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	363LF0000X	Family Nurse Practitioner	095905	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1992918114
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BARBARA E KING FNP-BC

Provider Business Mailing Address
First Line	:	9513 HIGHWAY 100
Second Line	:
City	:	NEW HAVEN
State	:	MO
Zip	:	63068-1300
Country	:	US
Telephone Number	:	573-237-6100
Fax Number	:

Provider Business Practice Location Address
First Line	:	9513 HIGHWAY 100
Second Line	:
City	:	NEW HAVEN
State	:	MO
Zip	:	63068-1300
Country	:	US
Telephone Number	:	573-237-6100
Fax Number	:	573-237-6101

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

Provider Enumeration Date	:	05/07/2007
Last Update Date	:	03/09/2018

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