Individual
KORETTA A KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
152 QUEENSBERRY CT, GREENSBORO, NC 27405-4899
(336) 254-3867
Mailing address
152 QUEENSBERRY CT, GREENSBORO, NC 27405-4899
(336) 254-3867
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
90647
NC
Other
Enumeration date
10/31/2020
Last updated
10/31/2020
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