Provider Demographics
NPI:1770059214
Name:KING, LINDSAY KATHRYN (PA-C)
Entity type:Individual
Prefix:
First Name:LINDSAY
Middle Name:KATHRYN
Last Name:KING
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4415 SCHOOL HOUSE CMNS
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:NC
Mailing Address - Zip Code:28075-7558
Mailing Address - Country:US
Mailing Address - Phone:904-571-8540
Mailing Address - Fax:
Practice Address - Street 1:4415 SCHOOL HOUSE CMNS
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:NC
Practice Address - Zip Code:28075-7558
Practice Address - Country:US
Practice Address - Phone:904-571-8540
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-23
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-08177363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant