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Individual

LILLIAN KENANI KING

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
715 N FIELDER RD, ARLINGTON, TX 76012-4695
(682) 220-9615
Mailing address
715 N FIELDER RD, ARLINGTON, TX 76012-4695
(682) 220-9615

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
139948
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
NONE
TX
Enumeration date
06/04/2019
Last updated
06/04/2019
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