Individual
MRS. DONELLE LYNN KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
530 3RD ST NW, ELK RIVER, MN 55330
(763) 587-4800
(763) 587-4885
Mailing address
8170 33RD AVE S, MS 21110Q, BLOOMINGTON, MN 55425-4516
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1942
MN
363LF0000X
Family Nurse Practitioner
0384015-22
IA
363LF0000X
Family Nurse Practitioner
R172511-9
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0424440
—
IA
Enumeration date
03/24/2006
Last updated
08/19/2022
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