Individual
TERRA KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
758 S WILLOW AVE, COOKEVILLE, TN 38501-3840
(931) 526-6173
(931) 526-5084
Mailing address
758 S WILLOW AVE, COOKEVILLE, TN 38501-3840
(931) 526-6173
(931) 526-5084
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
11247
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11247
STATE LICENSE
TN
Enumeration date
12/06/2010
Last updated
03/07/2023
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