Individual
MS. AMY M. KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
630 E RIVER ST, ELYRIA, OH 44035-5902
(440) 329-7500
Mailing address
630 E RIVER ST, ELYRIA, OH 44035-5902
(440) 329-7500
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
NP-08416
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2675574
—
OH
01
—
P00663386
MEDICARE RAILROAD
—
Enumeration date
06/08/2006
Last updated
04/07/2011
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