Provider Demographics
NPI:1871627661
Name:KING, BETTY (ARNP)
Entity type:Individual
Prefix:
First Name:BETTY
Middle Name:
Last Name:KING
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:524 KEAWE ST # 521
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-3101
Mailing Address - Country:US
Mailing Address - Phone:808-777-9460
Mailing Address - Fax:239-643-0529
Practice Address - Street 1:524 KEAWE ST # 521
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-3101
Practice Address - Country:US
Practice Address - Phone:808-777-9460
Practice Address - Fax:808-217-9174
Is Sole Proprietor?:No
Enumeration Date:2007-03-15
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIAPRN4055363LP0808X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLQ49472Medicare UPIN
FLU5325Medicare ID - Type Unspecified