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Individual

MRS. SAVANNAH MARIE KING

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
AG-ACNP

Contact information

Practice address
325 W WALNUT ST, LEBANON, KY 40033-1377
(270) 699-9500
Mailing address
4207 FRANCES DR, BARDSTOWN, KY 40004-8721
(502) 507-3311

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1134768
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1134768
KY
Enumeration date
02/06/2019
Last updated
02/06/2019
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