Provider Demographics
NPI:1588302038
Name:KING, CHRISTINE (PA-C)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:KING
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:375 COMMERCIAL CT STE E
Mailing Address - Street 2:
Mailing Address - City:VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34292-1623
Mailing Address - Country:US
Mailing Address - Phone:941-457-7700
Mailing Address - Fax:941-220-3327
Practice Address - Street 1:375 COMMERCIAL CT STE E
Practice Address - Street 2:
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34292-1623
Practice Address - Country:US
Practice Address - Phone:941-457-7700
Practice Address - Fax:941-220-3327
Is Sole Proprietor?:No
Enumeration Date:2022-05-24
Last Update Date:2024-02-14
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant