Individual
LILY MICHELLE KING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
21 BENNETT LN, PALM COAST, FL 32137-8610
(386) 315-1260
Mailing address
PO BOX 350373, PALM COAST, FL 32135-0373
(386) 315-1260
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
5212850
FL
251E00000X
Home Health Agency
—
—
261QD1600X
Developmental Disabilities Clinic/Center
—
—
372600000X
Adult Companion
—
—
376J00000X
Homemaker
—
—
385H00000X
Respite Care
—
—
Other
Enumeration date
06/01/2018
Last updated
07/29/2024
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