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Individual

LARA N. KING

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
4803 29TH AVE STE A, MERIDIAN, MS 39305-2675
(601) 286-5477
(601) 286-5825
Mailing address
4803 29TH AVE STE A, MERIDIAN, MS 39305-2675
(601) 286-5477
(601) 286-5825

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R856339
MS
363LF0000X
Family Nurse Practitioner
R856339
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01384559
MS
Enumeration date
10/05/2011
Last updated
06/05/2024
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