Provider Demographics
NPI:1184256489
Name:KING, SYLVIA (NP)
Entity type:Individual
Prefix:
First Name:SYLVIA
Middle Name:
Last Name:KING
Suffix:
Gender:
Credentials:NP
Other - Prefix:
Other - First Name:SYLVIA
Other - Middle Name:
Other - Last Name:KING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1564 N RAMAH DR
Mailing Address - Street 2:
Mailing Address - City:PUEBLO WEST
Mailing Address - State:CO
Mailing Address - Zip Code:81007-3450
Mailing Address - Country:US
Mailing Address - Phone:719-439-4067
Mailing Address - Fax:
Practice Address - Street 1:44 E. SPAULDING AVE, BLDG 3, STE 4
Practice Address - Street 2:
Practice Address - City:PUEBLO WEST
Practice Address - State:CO
Practice Address - Zip Code:81007-1668
Practice Address - Country:US
Practice Address - Phone:719-289-6002
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-05
Last Update Date:2025-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0995268-NP363LA2200X, 363LG0600X, 363LP2300X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care