Provider Demographics
NPI:1447865795
Name:KING, VIOLET ELVIRA
Entity type:Individual
Prefix:MS
First Name:VIOLET
Middle Name:ELVIRA
Last Name:KING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 SANTA FE RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:OH
Mailing Address - Zip Code:45042-3634
Mailing Address - Country:US
Mailing Address - Phone:513-649-7557
Mailing Address - Fax:
Practice Address - Street 1:200 SANTA FE RD
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:OH
Practice Address - Zip Code:45042-3634
Practice Address - Country:US
Practice Address - Phone:513-649-7557
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-14
Last Update Date:2020-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide