Individual
KELLI A L KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1021 S COTTONWOOD ST, NORTH PLATTE, NE 69101-6138
(308) 534-4438
(308) 534-4190
Mailing address
1021 S COTTONWOOD ST, NORTH PLATTE, NE 69101-6138
(308) 534-4438
(308) 534-4190
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
110673
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100264810-00
—
NE
01
—
38966
BCBS PROVIDER#
—
01
—
DV8242
MEDICARE RR FOR BUSINESS
NE
01
—
P01500120
MEDICARE RR FOR KELLI
NE
Enumeration date
01/03/2007
Last updated
03/23/2020
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