Provider Demographics
NPI:1467518092
Name:KING, CARL (RN)
Entity Type:Individual
Prefix:MR
First Name:CARL
Middle Name:
Last Name:KING
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:820 MAGYAR RD
Mailing Address - Street 2:
Mailing Address - City:STEDMAN
Mailing Address - State:NC
Mailing Address - Zip Code:28391-9434
Mailing Address - Country:US
Mailing Address - Phone:910-717-5703
Mailing Address - Fax:
Practice Address - Street 1:820 MAGYAR RD
Practice Address - Street 2:
Practice Address - City:STEDMAN
Practice Address - State:NC
Practice Address - Zip Code:28391-9434
Practice Address - Country:US
Practice Address - Phone:910-717-5703
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC158855163WE0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WE0003XNursing Service ProvidersRegistered NurseEmergency