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Individual

MS. BRENDA KING

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
N.P.

Contact information

Practice address
1250 E MARSHALL ST, DERMATOLOGY, RICHMOND, VA 23298-5051
(804) 828-0300
(804) 560-8993
Mailing address
2600 GLASGOW AVE, STE 100, NEWARK, DE 19702-5703
(804) 358-6100
(804) 342-7619

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0024130834
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
P00372859
RR MEDICARE
VA
Enumeration date
07/18/2006
Last updated
11/21/2017
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