King, Theresa Renee
King, Theresa Renee is an sole proprietor health care provider with primary practice located at 427 Highway 51 N , Brookhaven MS 39601-2350. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. King, Theresa Renee can be contacted via phone (601) 826-5500.Contact Information
Primary practice address
427 Highway 51 N
Brookhaven MS 39601-2350
Phone: (601) 826-5500
Fax: (601) 420-5299
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | R873560 | Mississippi |
Profile Details
| NPI number | 1669576989 |
|---|---|
| LBN Legal business name | King, Theresa Renee |
| Credentials | RN, CFNP |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 8th, 2006 |
| Last updated | Oct 20th, 2015 - about 10 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1669576989 | NPPES |
| Mississippi | MEDICAID | 02572058 |
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