Provider Demographics
NPI:1366686347
Name:KING, ANN THOMAS (CNM)
Entity Type:Individual
Prefix:MISS
First Name:ANN
Middle Name:THOMAS
Last Name:KING
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35670 KENAI SPUR HWY STE 101A
Mailing Address - Street 2:
Mailing Address - City:SOLDOTNA
Mailing Address - State:AK
Mailing Address - Zip Code:99669-7649
Mailing Address - Country:US
Mailing Address - Phone:907-262-2602
Mailing Address - Fax:907-262-5794
Practice Address - Street 1:35670 KENAI SPUR HWY STE 101A
Practice Address - Street 2:
Practice Address - City:SOLDOTNA
Practice Address - State:AK
Practice Address - Zip Code:99669-7649
Practice Address - Country:US
Practice Address - Phone:907-262-2602
Practice Address - Fax:907-262-5794
Is Sole Proprietor?:No
Enumeration Date:2009-04-22
Last Update Date:2020-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK155661367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife