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Individual

KIMBERLY S KING

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
303 NW 11TH ST, FAIRFIELD, IL 62837-1206
(618) 842-2611
(618) 847-8360
Mailing address
303 NW 11TH ST, FAIRFIELD, IL 62837-1206
(618) 842-2611
(618) 847-8360

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
55479
KS
207LP2900X
Pain Medicine (Anesthesiology) Physician
209-007060
IL
367500000X
Certified Registered Nurse Anesthetist
Primary
201802897CRNA
OR
367500000X
Certified Registered Nurse Anesthetist
55479
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200363250A
KS
05
500743849
OR
Enumeration date
04/13/2006
Last updated
08/11/2025
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