Individual
GEORGE KEITH KING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
307 BUCKEYE RIDGE LOOP, DEVILLE, LA 71328-8515
(318) 613-4762
Mailing address
919 HIDDEN RDG, IRVING, TX 75038-3813
(469) 282-2711
(469) 282-2609
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
AP07397
LA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP07397
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2369199
—
LA
Enumeration date
07/01/2013
Last updated
07/10/2019
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