Individual
JENNIFER ANN KING-WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
500 UNIVERSITY DR, HERSHEY, PA 17033
(800) 243-1455
Mailing address
PO BOX 858, MC A410, HERSHEY, PA 17033-0858
(800) 243-1455
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
SP010087
PA
367500000X
Certified Registered Nurse Anesthetist
Primary
RN505448L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1031605010001
—
PA
01
—
SP010087
MEDICAL LICENSE
PA
Enumeration date
12/11/2008
Last updated
10/16/2019
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