Individual
VIRGINIA KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1601 W 4TH ST, COFFEYVILLE, KS 67337-3333
(620) 251-8180
Mailing address
1601 W 4TH ST, COFFEYVILLE, KS 67337-3333
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
107
KS
363AM0700X
Medical Physician Assistant
Primary
15-01712
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200436960A
—
KS
Enumeration date
09/24/2006
Last updated
09/04/2014
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