Individual
JENNIFER KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
855 MONTGOMERY ST, FORT WORTH, TX 76107-2553
(817) 735-2200
(817) 735-5441
Mailing address
855 MONTGOMERY ST, FORT WORTH, TX 76107-2553
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
1109782
TX
363LP2300X
Primary Care Nurse Practitioner
1109782
TX
Other
Enumeration date
01/31/2023
Last updated
11/10/2023
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