Provider Demographics
NPI:1427578855
Name:KING, LORI DAWN (APRN)
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:DAWN
Last Name:KING
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:799 E BRANNON RD
Mailing Address - Street 2:
Mailing Address - City:NICHOLASVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40356-6038
Mailing Address - Country:US
Mailing Address - Phone:859-971-4658
Mailing Address - Fax:859-971-4604
Practice Address - Street 1:55 THANNOLI DR
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:KY
Practice Address - Zip Code:42503-2861
Practice Address - Country:US
Practice Address - Phone:606-677-0854
Practice Address - Fax:606-677-9311
Is Sole Proprietor?:No
Enumeration Date:2017-06-27
Last Update Date:2020-12-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KY3011427363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily