Basic Information
| Provider Information | |||||||||
| NPI: | 1588913602 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KING | ||||||||
| FirstName: | ALLISON | ||||||||
| MiddleName: | RENE | ||||||||
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| Credential: | CNM, MSN, ARNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 785 PRIMERA BLVD STE 1031 | ||||||||
| Address2: | |||||||||
| City: | LAKE MARY | ||||||||
| State: | FL | ||||||||
| PostalCode: | 327462124 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4078348111 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 785 PRIMERA BLVD STE 1031 | ||||||||
| Address2: | |||||||||
| City: | LAKE MARY | ||||||||
| State: | FL | ||||||||
| PostalCode: | 327462124 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4078348111 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/05/2012 | ||||||||
| LastUpdateDate: | 04/10/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367A00000X | ARNP9277883 | FL | Y | Physician Assistants & Advanced Practice Nursing Providers | Advanced Practice Midwife |
No ID Information.