Individual
ALEASA MARIE KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
550 TRUMBULL AVE, CORTLAND, OH 44410-9403
(330) 637-2000
(330) 637-2001
Mailing address
550 TRUMBULL AVE, CORTLAND, OH 44410-9403
(330) 637-2000
(330) 637-2001
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
APRN.CNP.020515
OH
363LF0000X
Family Nurse Practitioner
RN372312
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0212509
—
OH
01
—
13985516
CAQH
—
01
—
CS1721200113
CARESOURCE
OH
Enumeration date
02/21/2017
Last updated
07/21/2021
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