Provider Demographics
NPI:1881035467
Name:KING, KARLA G (APRN)
Entity Type:Individual
Prefix:
First Name:KARLA
Middle Name:G
Last Name:KING
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3240 MOUNT MORIAH AVE
Mailing Address - Street 2:
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42303-7805
Mailing Address - Country:US
Mailing Address - Phone:270-929-2642
Mailing Address - Fax:270-686-6140
Practice Address - Street 1:3240 MOUNT MORIAH AVE
Practice Address - Street 2:
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42303-7805
Practice Address - Country:US
Practice Address - Phone:270-929-2642
Practice Address - Fax:270-686-6140
Is Sole Proprietor?:No
Enumeration Date:2013-07-11
Last Update Date:2013-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3008055363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health