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Individual
MAXINE MILLICENT KING
Active
Individual
MAXINE MILLICENT KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
12634
CT
363L00000X
Nurse Practitioner
Primary
95028329
CA
363L00000X
Nurse Practitioner
AC003700
MD
363LG0600X
Gerontology Nurse Practitioner
AC003700
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
APRN002718
STATE LICENSE
NV
Enumeration date
11/10/2017
Last updated
01/08/2026
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