Individual
DR. SIMONE E KING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNPCE-DNP
Contact information
Practice address
815 BUSINESS PARK DR STE A, TRAVERSE CITY, MI 49686-8683
(925) 876-1887
Mailing address
815 BUSINESS PARK DR STE A, TRAVERSE CITY, MI 49686-8683
(925) 876-1887
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
4704158711
MI
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
95019084
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1487317509
—
MI
Enumeration date
10/15/2021
Last updated
12/08/2022
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