Individual
MONA LORRAINE KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
909 FULTON ST SE, MINNEAPOLIS, MN 55455-4009
(612) 672-7422
(612) 676-8992
Mailing address
909 FULTON ST SE, MINNEAPOLIS, MN 55455-4800
(612) 672-7422
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP131794/RN 906115
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
365270301
—
TX
Enumeration date
07/20/2015
Last updated
03/01/2018
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