Provider Demographics
NPI:1407357726
Name:KING, HOPE LYNN
Entity Type:Individual
Prefix:
First Name:HOPE
Middle Name:LYNN
Last Name:KING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7740 RANCHO SANTA FE RD
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92009-8685
Mailing Address - Country:US
Mailing Address - Phone:256-899-9189
Mailing Address - Fax:
Practice Address - Street 1:11588 PULASKI PIKE
Practice Address - Street 2:
Practice Address - City:TONEY
Practice Address - State:AL
Practice Address - Zip Code:35773-9381
Practice Address - Country:US
Practice Address - Phone:256-428-7561
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-22
Last Update Date:2023-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95009667363LF0000X
AL1-133403363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL6811Medicaid