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Individual

MRS. MELISSA E KING

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ACNP-BC

Contact information

Practice address
1907 W SYCAMORE ST, KOKOMO, IN 46901-5148
(765) 456-5433
Mailing address
250 W 96TH ST # 520, INDIANAPOLIS, IN 46260-1316

Taxonomy

Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
71005010A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
201251490
IN
01
471400530
MEDICARE
IN
Enumeration date
07/17/2014
Last updated
05/08/2021
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