Individual
JENNIFER KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4315 CHAIN BRIDGES ROAD, FALLS CHURCH, VA 22030
(703) 776-3111
(904) 346-0113
Mailing address
2411 DAKOTA LAKES DR, HERNDON, VA 20171-2994
(703) 810-8406
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
0101052115
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006091504
—
VA
05
—
010064848
—
VA
01
—
0101052115
UNICARE
VA
01
—
211052
ANTHEM
VA
05
—
5816947
—
VA
Enumeration date
09/05/2006
Last updated
06/11/2008
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