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Individual

TAMARA LEIGH KING

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNP

Contact information

Practice address
4704 WHITESBURG DR SW, SUITE 201, HUNTSVILLE, AL 35802-1679
(256) 213-1800
(256) 429-9186
Mailing address
4704 WHITESBURG DR SW, SUITE 201, HUNTSVILLE, AL 35802-1679
(256) 213-1800
(256) 429-9186

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1-101199
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
102I500479
MEDICARE
AL
05
164230
AL
05
164252
AL
05
164618
AL
01
511-53710.
BCBS
AL
01
511-53711
BCBS
AL
01
511-53712
BCBS
AL
Enumeration date
12/01/2010
Last updated
08/13/2015
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