Provider Demographics
NPI:1134199391
Name:KING, RITA K (FNP)
Entity type:Individual
Prefix:MS
First Name:RITA
Middle Name:K
Last Name:KING
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:RITA
Other - Middle Name:KAY
Other - Last Name:SCHOWENGERDT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:190 COMMUNITY CENTER DR
Mailing Address - Street 2:SUITE 103
Mailing Address - City:PIGEON FORGE
Mailing Address - State:TN
Mailing Address - Zip Code:37863-6251
Mailing Address - Country:US
Mailing Address - Phone:865-446-4032
Mailing Address - Fax:865-868-4746
Practice Address - Street 1:190 COMMUNITY CENTER DR
Practice Address - Street 2:SUITE 103
Practice Address - City:PIGEON FORGE
Practice Address - State:TN
Practice Address - Zip Code:37863-6251
Practice Address - Country:US
Practice Address - Phone:865-446-4032
Practice Address - Fax:865-868-4746
Is Sole Proprietor?:No
Enumeration Date:2006-01-23
Last Update Date:2015-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP2709232363L00000X
TN363A00000X
TNAPN0000012584363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL307909100Medicaid
FLP00671453OtherMEDICARE RR
FLY037WVMedicare PIN
FL307909100Medicaid