Provider Demographics
NPI:1972287621
Name:KING, LAWRUNDA TOMIKA
Entity Type:Individual
Prefix:
First Name:LAWRUNDA
Middle Name:TOMIKA
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 1:1406 N 23RD ST
Mailing Address - Street 2:
Mailing Address - City:FORT PIERCE
Mailing Address - State:FL
Mailing Address - Zip Code:34950-2033
Mailing Address - Country:US
Mailing Address - Phone:772-771-4349
Mailing Address - Fax:
Practice Address - Street 1:1406 N 23RD ST
Practice Address - Street 2:
Practice Address - City:FORT PIERCE
Practice Address - State:FL
Practice Address - Zip Code:34950-2033
Practice Address - Country:US
Practice Address - Phone:772-771-4349
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-13
Last Update Date:2023-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide