Individual
KEITH TISHEEM KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-C
Contact information
Practice address
5070 INTERNATIONAL BLVD STE 131, NORTH CHARLESTON, SC 29418-6007
(843) 402-5053
(843) 724-1325
Mailing address
PO BOX 751649, CHARLOTTE, NC 28275-1649
(888) 472-0043
(843) 724-2440
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
25025
SC
363LF0000X
Family Nurse Practitioner
Primary
25025
SC
Other
Enumeration date
06/03/2021
Last updated
10/03/2024
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