Provider Demographics
NPI:1447571153
Name:KING, DEVON A
Entity Type:Individual
Prefix:
First Name:DEVON
Middle Name:A
Last Name:KING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DEVON
Other - Middle Name:A
Other - Last Name:KING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:16305 MORAN ST
Mailing Address - Street 2:B
Mailing Address - City:FORT POLK
Mailing Address - State:LA
Mailing Address - Zip Code:71459-2569
Mailing Address - Country:US
Mailing Address - Phone:337-303-2949
Mailing Address - Fax:
Practice Address - Street 1:16305 MORAN ST
Practice Address - Street 2:B
Practice Address - City:FORT POLK
Practice Address - State:LA
Practice Address - Zip Code:71459-2569
Practice Address - Country:US
Practice Address - Phone:337-303-2949
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-16
Last Update Date:2010-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula