Individual
DR. KELLY ANN KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1835 ODDIE BLVD, SPARKS, NV 89431-3559
(775) 982-5140
(775) 982-5141
Mailing address
780 KUENZLI ST STE 202, RENO, NV 89502-0837
(775) 982-4590
(775) 982-4595
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
11634
NV
208M00000X
Hospitalist Physician
11634
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12274748
CAQH
NV
05
—
1659355410
—
NV
Enumeration date
12/05/2005
Last updated
02/24/2016
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