Individual
MRS. NICHOLE A KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2577 W GREENWAY RD, PHOENIX, AZ 85023-4308
(602) 375-1777
(602) 993-0588
Mailing address
2577 W GREENWAY RD, PHOENIX, AZ 85023-4308
(602) 375-1777
(602) 993-0588
Taxonomy
Speciality
Code
Description
License number
State
376G00000X
Nursing Home Administrator
Primary
ALM012210
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
81-860132
ASSISTED LIVING
AZ
Enumeration date
02/02/2022
Last updated
02/02/2022
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