Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | 71007285A | IN |
N | 363LG0600X | Nurse Practitioner - Gerontology | 71007285A | IN |
NPI | 1033649165 |
---|---|
Provider Name | Mrs. Whitney Leigh King |
First Address | Indianapolis, IN 46260-1316 |
Second Address | Indianapolis, IN 46260-1992 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2017 |
Last Update Date | 04/02/2019 |