Provider Demographics
NPI:1811472590
Name:KING, DOROTHY HELEN (LPN)
Entity type:Individual
Prefix:
First Name:DOROTHY
Middle Name:HELEN
Last Name:KING
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17126 STATE HIGHWAY 285
Mailing Address - Street 2:
Mailing Address - City:COCHRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:16314-4526
Mailing Address - Country:US
Mailing Address - Phone:172-445-6723
Mailing Address - Fax:
Practice Address - Street 1:1109 EAST ST
Practice Address - Street 2:
Practice Address - City:HERMITAGE
Practice Address - State:PA
Practice Address - Zip Code:16148-1265
Practice Address - Country:US
Practice Address - Phone:724-456-7236
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-28
Last Update Date:2018-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPN261820164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse