Provider Demographics
NPI:1679077358
Name:KING, ELIZABETH E (FNP-C)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:E
Last Name:KING
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:ERIN
Other - Last Name:MESSMORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:660 MASON RIDGE CENTER DR
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-8509
Mailing Address - Country:US
Mailing Address - Phone:314-273-6481
Mailing Address - Fax:
Practice Address - Street 1:660 MASON RIDGE CENTER DR
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-8509
Practice Address - Country:US
Practice Address - Phone:314-273-6481
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-19
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209024767363L00000X, 363LF0000X
MO2017042344363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily