Provider Demographics
NPI:1518511021
Name:KING, EFFIEN (FNP)
Entity Type:Individual
Prefix:MRS
First Name:EFFIEN
Middle Name:
Last Name:KING
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:143 LONGWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02908-1121
Mailing Address - Country:US
Mailing Address - Phone:323-770-6210
Mailing Address - Fax:
Practice Address - Street 1:126 PROSPECT ST STE 105
Practice Address - Street 2:
Practice Address - City:PAWTUCKET
Practice Address - State:RI
Practice Address - Zip Code:02860-4429
Practice Address - Country:US
Practice Address - Phone:401-753-2526
Practice Address - Fax:401-235-4152
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-01
Last Update Date:2021-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIF06192202363LF0000X
RIAPRN02620364SP0810X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes364SP0810XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Child & Family
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty