Provider Demographics
NPI:1548934128
Name:KING, NATHAN P (PMHNP)
Entity type:Individual
Prefix:
First Name:NATHAN
Middle Name:P
Last Name:KING
Suffix:
Gender:M
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1350 OLD FREEPORT RD STE 1A
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15238-3122
Mailing Address - Country:US
Mailing Address - Phone:724-742-1888
Mailing Address - Fax:
Practice Address - Street 1:1350 OLD FREEPORT RD STE 1A
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15238-3122
Practice Address - Country:US
Practice Address - Phone:724-742-1888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-06
Last Update Date:2023-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP023104363LF0000X
PASP027596363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily