Individual
STACEY KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
21141 STATE HIGHWAY 59 STE 1, ROBERTSDALE, AL 36567-6740
(251) 424-1160
(251) 424-1161
Mailing address
21141 STATE HIGHWAY 59 STE 1, ROBERTSDALE, AL 36567-6740
(251) 424-1160
(251) 424-1161
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1-103735
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
207558
—
AL
Enumeration date
06/15/2015
Last updated
11/13/2020
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