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Individual

MARSHA LYNN KING

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
5323 HARRY HINES BLVD, DALLAS, TX 75390-7201
(214) 645-0325
Mailing address
PO BOX 845347, DALLAS, TX 75284-5347

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
AP112817
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
171166501
TX
05
171166503
TX
01
83834U
BLUE CROSS PROVIDER ID
TX
01
P00197296
RAILROAD MEDICARE
Enumeration date
01/11/2007
Last updated
03/02/2017
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