Kellie King, CSW-INTERN

NPI 1780199828 · on the registry since 2017 · sole proprietor

Practice

Address: 90 Hope Dr Bldg 6000
Mountain Home Afb, ID 83648
Phone: (208) 828-7580
Organisation at this address: Mt Home Refill Phcy
366th Medical Group Sgsl
366th Medgrp-Mountain Home
366th Medgrp-Mountain Home
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 90

Registry record

Primary taxonomy: 1041C0700X
1041C0700X
Licence states on file: NV
From the registry's licence fields, which are often incomplete.
Sex: Female
Record last updated: 2023-07-12

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Idaho