Provider Demographics
NPI:1972780435
Name:KING, GARNET FOSTER (APRN, BC)
Entity Type:Individual
Prefix:MRS
First Name:GARNET
Middle Name:FOSTER
Last Name:KING
Suffix:
Gender:F
Credentials:APRN, BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:465 WINN WAY STE 221
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30030-1723
Mailing Address - Country:US
Mailing Address - Phone:404-292-3810
Mailing Address - Fax:404-292-3848
Practice Address - Street 1:465 WINN WAY STE 221
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30030-1723
Practice Address - Country:US
Practice Address - Phone:404-292-3810
Practice Address - Fax:404-292-3848
Is Sole Proprietor?:No
Enumeration Date:2008-01-28
Last Update Date:2022-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN076787364SP0810X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0810XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Child & Family