Provider Demographics
NPI:1548393861
Name:KING, LINDA
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:
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:PO BOX 1281
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71309-1281
Mailing Address - Country:US
Mailing Address - Phone:318-730-6988
Mailing Address - Fax:318-484-6228
Practice Address - Street 1:2129 RAINBOW DR
Practice Address - Street 2:242 W SHAMROCK STREET
Practice Address - City:PINEVILLE
Practice Address - State:LA
Practice Address - Zip Code:71360-6449
Practice Address - Country:US
Practice Address - Phone:318-484-6469
Practice Address - Fax:318-484-6228
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant