Tracy King, LPN

Individual provider Active NPI Licensed Practical Nurse · Addyston, OH

NPI 1992044796 · NPPES record last updated Feb 14, 2013

Key facts

NPI
1992044796
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
PN 83131 (OH)
Practice address
587 Box Lane
Addyston, OH 45001
Phone
(859) 307-6364
NPI assigned
Feb 14, 2013
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
PN 83131OHMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X PN 83131 OH Yes

Addresses

Primary practice location

587 Box Lane
Addyston, OH 45001

Mailing address

PO Box 587
Addyston, OH 45001
Phone (859) 307-6364

Other providers in Addyston, OH

All providers in Addyston, OH · Licensed Practical Nurse in Ohio

Sources for this page

Verify at the official NPI Registry.