Provider Demographics
NPI:1871962340
Name:KING, NATALIE
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:
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 1:336 N MASSEY BLVD
Mailing Address - Street 2:
Mailing Address - City:NIXA
Mailing Address - State:MO
Mailing Address - Zip Code:65714-8307
Mailing Address - Country:US
Mailing Address - Phone:417-725-0900
Mailing Address - Fax:417-725-0903
Practice Address - Street 1:336 N MASSEY BLVD
Practice Address - Street 2:
Practice Address - City:NIXA
Practice Address - State:MO
Practice Address - Zip Code:65714-8307
Practice Address - Country:US
Practice Address - Phone:417-725-0900
Practice Address - Fax:417-725-0903
Is Sole Proprietor?:No
Enumeration Date:2015-09-15
Last Update Date:2015-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2014023087237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist