Individual
TERESA KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP, GNP, FNP
Contact information
Practice address
4974 MANCHESTER AVE, SAINT LOUIS, MO 63110-2010
(314) 289-6566
(314) 289-6566
Mailing address
4974 MANCHESTER AVE, SAINT LOUIS, MO 63110-2010
(314) 289-6566
(314) 289-6566
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
146904
MO
363L00000X
Nurse Practitioner
209-006077
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
041-330101
IL RN LICENSE
IL
01
—
209-006077
IL APN LICENSE
IL
Enumeration date
03/30/2007
Last updated
03/23/2012
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