Individual
TARA SUE KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ACNP
Contact information
Practice address
433 MARIBELLA CT, ST AUGUSTINE, FL 32086-7749
(484) 788-3387
Mailing address
PO BOX 100288, GAINESVILLE, FL 32610-0277
(352) 273-9079
(352) 273-8889
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
11026947
FL
363LA2100X
Acute Care Nurse Practitioner
Primary
11026947
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
119811000
—
FL
Enumeration date
08/07/2023
Last updated
02/03/2026
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