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Individual

MR. EVAN KING

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
RNFA

Contact information

Practice address
52 PIONEER TRL, MARIETTA, GA 30068
(256) 601-6794
Mailing address
52 PIONEER TRL, MARIETTA, GA 30068-3400
(256) 601-6794

Taxonomy

Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
Primary
RN234991
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
RN234991
REGISTERED NURSE
GA
Enumeration date
08/01/2017
Last updated
07/21/2022
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