# DR WENDY KING, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1164751103
- **Authorized official:** DR. EDWINA SKIBA-KING APRN, PHD (SOLE MEMBER)
- **Authorized official phone:** (732) 322-5769

## Contact information

- **Practice address:** 53 KOSSUTH ST, FIRST FLOOR, SOMERSET, NJ 08873-2660
- **Practice address phone:** (732) 322-5769
- **Practice address fax:** (732) 565-9225
- **Mailing address:** 53 KOSSUTH ST, FIRST FLOOR, SOMERSET, NJ 08873-2660
- **Mailing address phone:** (732) 322-5769
- **Mailing address fax:** (732) 565-9225

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | 26NC04861500 | NJ | Yes |
| 364SP0808X | Psychiatric/Mental Health Clinical Nurse Specialist | 26NC04861500 | NJ | — |

## Other

- **Enumeration date:** 12/22/2009
- **Last updated:** 12/22/2009