Individual
DR. STEPHANIE G KING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
307 N MAIN ST, ATHENS, PA 18810-1710
(570) 888-1541
(570) 888-2380
Mailing address
307 N MAIN ST, ATHENS, PA 18810-1710
(570) 888-1541
(570) 888-2380
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
SP011532
PA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
SP011532
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1026337300001
—
PA
01
—
2664595
HIGHMARK BLUE SHIELD
PA
01
—
828418
FIRST PRIORITY HEALTH
PA
01
—
9611934
AETNA
PA
Enumeration date
08/08/2011
Last updated
11/17/2014
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