# NAUTICA KING

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1619748688
- **Gender:** F

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163W00000X | Registered Nurse | R258768 | MD | — |
| 163WP0808X | Psychiatric/Mental Health Registered Nurse | RN500016537 | DC | Yes |

## Other

- **Enumeration date:** 01/09/2024
- **Last updated:** 09/04/2024