Individual
JACI KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2135 ZETUS RD NW, BROOKHAVEN, MS 39601
(601) 757-9927
Mailing address
2135 ZETUS RD NW, BROOKHAVEN, MS 39601
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
913647
MS
Other
Enumeration date
03/24/2021
Last updated
03/24/2021
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