Provider Demographics
NPI:1386917656
Name:KING, MARIANNE P (RN)
Entity type:Individual
Prefix:
First Name:MARIANNE
Middle Name:P
Last Name:KING
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 ZACHARY TAYLOR ST
Mailing Address - Street 2:
Mailing Address - City:STONY POINT
Mailing Address - State:NY
Mailing Address - Zip Code:10980-3608
Mailing Address - Country:US
Mailing Address - Phone:845-942-8352
Mailing Address - Fax:
Practice Address - Street 1:11 ZACHARY TAYLOR ST
Practice Address - Street 2:
Practice Address - City:STONY POINT
Practice Address - State:NY
Practice Address - Zip Code:10980-3608
Practice Address - Country:US
Practice Address - Phone:845-942-8352
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-17
Last Update Date:2012-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY573911-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse