Provider Demographics
NPI:1295842151
Name:KING, DEBRA KAY (CNP)
Entity Type:Individual
Prefix:MS
First Name:DEBRA
Middle Name:KAY
Last Name:KING
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7777 US HIGHWAY 23
Mailing Address - Street 2:
Mailing Address - City:PIKETON
Mailing Address - State:OH
Mailing Address - Zip Code:45661-9102
Mailing Address - Country:US
Mailing Address - Phone:740-289-3508
Mailing Address - Fax:740-289-8951
Practice Address - Street 1:7777 US HIGHWAY 23
Practice Address - Street 2:
Practice Address - City:PIKETON
Practice Address - State:OH
Practice Address - Zip Code:45661-9102
Practice Address - Country:US
Practice Address - Phone:740-289-3508
Practice Address - Fax:740-289-8951
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2010-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA.08826-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2669250Medicaid
OH2669250Medicaid
Q70893Medicare UPIN