Individual
MRS. NATHALIE ANNE KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
3805B SPRING ST, SUITE 320, RACINE, WI 53405-1641
(262) 687-8322
Mailing address
3805B SPRING ST, SUITE 320, RACINE, WI 53405-1641
(262) 687-8322
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1807
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
39-1264986
TAX ID
WI
Enumeration date
08/30/2006
Last updated
01/03/2011
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