Provider Demographics
NPI:1740078641
Name:KING, KEYUNNA M
Entity type:Individual
Prefix:
First Name:KEYUNNA
Middle Name:M
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 1:560 W MAIN ST STE 203
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75057-3604
Mailing Address - Country:US
Mailing Address - Phone:469-470-4870
Mailing Address - Fax:214-379-3322
Practice Address - Street 1:560 W MAIN ST STE 203
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75057-3604
Practice Address - Country:US
Practice Address - Phone:469-470-4870
Practice Address - Fax:214-379-3322
Is Sole Proprietor?:No
Enumeration Date:2025-04-29
Last Update Date:2025-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator