Individual
LISA KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
2580 JACKSON AVE W STE 44, OXFORD, MS 38655-5497
(662) 234-9112
Mailing address
2667 HIGHWAY 145, SALTILLO, MS 38866-9771
(662) 269-2532
(662) 601-2298
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
879505
MS
363LF0000X
Family Nurse Practitioner
Primary
904865
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00018203
—
MS
Enumeration date
08/23/2019
Last updated
05/13/2026
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