Provider Demographics
NPI:1720285737
Name:KING, RITA K (RN)
Entity type:Individual
Prefix:MRS
First Name:RITA
Middle Name:K
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 1:46 STATE ROUTE 502
Mailing Address - Street 2:46 STATE ROUTE 502
Mailing Address - City:UNION CITY
Mailing Address - State:OH
Mailing Address - Zip Code:45390
Mailing Address - Country:US
Mailing Address - Phone:937-968-6067
Mailing Address - Fax:937-968-3361
Practice Address - Street 1:46 STATE ROUTE 502
Practice Address - Street 2:46 STATE ROUTE 502
Practice Address - City:UNION CITY
Practice Address - State:OH
Practice Address - Zip Code:45390
Practice Address - Country:US
Practice Address - Phone:937-968-6067
Practice Address - Fax:937-968-3361
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.320186163W00000X
IN28163719A163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse