Provider Demographics
NPI:1932343845
Name:KING, ABBE DREW (NP)
Entity type:Individual
Prefix:
First Name:ABBE
Middle Name:DREW
Last Name:KING
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 129
Mailing Address - Street 2:26624 POOLS CREEK DRIVE
Mailing Address - City:OAKHURST
Mailing Address - State:TX
Mailing Address - Zip Code:77359
Mailing Address - Country:US
Mailing Address - Phone:936-891-5399
Mailing Address - Fax:
Practice Address - Street 1:ELLIS PRISON
Practice Address - Street 2:1697 FM 980
Practice Address - City:HUNTSVILLE
Practice Address - State:TX
Practice Address - Zip Code:77343-0001
Practice Address - Country:US
Practice Address - Phone:936-295-5756
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-22
Last Update Date:2009-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP1362363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily