Individual
AMY MICHELLE KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
556 N OAKWOOD DR, WICHITA, KS 67208-4227
(310) 497-6537
Mailing address
7331 PLAZA LN, WICHITA, KS 67206-2125
(310) 497-6537
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
55701
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200592480A
—
KS
01
—
P00765672
RR MEDICARE GROUP CQ2302
KS
Enumeration date
05/29/2008
Last updated
12/07/2022
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