Individual
JERMONIQUE KING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
PO BOX 98, FAYETTE, MS 39069-0098
(601) 786-3475
(601) 786-9980
Mailing address
PO BOX 98, FAYETTE, MS 39069-0098
(601) 786-3475
(601) 786-9980
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
877508
MS
363LF0000X
Family Nurse Practitioner
Primary
R877508
MS
Other
Enumeration date
01/17/2014
Last updated
10/17/2024
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