Provider Demographics
NPI:1013937762
Name:KING, MICHELLE WASHINGTON (RN)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:WASHINGTON
Last Name:KING
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:960 WASHINGTON RD
Mailing Address - Street 2:
Mailing Address - City:PICKENSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35447-3640
Mailing Address - Country:US
Mailing Address - Phone:205-367-8068
Mailing Address - Fax:205-367-1928
Practice Address - Street 1:960 WASHINGTON RD
Practice Address - Street 2:
Practice Address - City:PICKENSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35447-3640
Practice Address - Country:US
Practice Address - Phone:205-367-8068
Practice Address - Fax:205-367-1928
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR874565163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health