Individual
ALICE LOUIETTA KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
3000 S MCCALL RD, ENGLEWOOD, FL 34224-8616
(941) 406-9029
(941) 406-9028
Mailing address
2675 WINKLER AVE FL 2, FORT MYERS, FL 33901-9342
(877) 856-3774
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APN7423
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
37066302
MEDICARE LEGACY GROUP
TN
01
—
500028563
RR MEDICARE PIN
TN
Enumeration date
06/27/2006
Last updated
09/15/2021
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