Provider Demographics
NPI:1053417329
Name:KING, PATRICIA NABORS (NP)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:NABORS
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:PO BOX 3768
Mailing Address - Street 2:
Mailing Address - City:MERCED
Mailing Address - State:CA
Mailing Address - Zip Code:95344-3768
Mailing Address - Country:US
Mailing Address - Phone:209-667-0702
Mailing Address - Fax:209-667-6737
Practice Address - Street 1:1600 CREEKSIDE DR STE 2100
Practice Address - Street 2:
Practice Address - City:FOLSOM
Practice Address - State:CA
Practice Address - Zip Code:95630-3447
Practice Address - Country:US
Practice Address - Phone:916-983-2663
Practice Address - Fax:916-983-2663
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CANP12519363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner