Individual
JACQUELINE KING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
196 E EMMITT AVE, WAVERLY, OH 45690-1334
(407) 947-6727
Mailing address
196 E EMMITT AVE, WAVERLY, OH 45690-1334
(407) 947-6727
Taxonomy
Speciality
Code
Description
License number
State
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
Primary
330473
OH
Other
Enumeration date
03/20/2015
Last updated
03/21/2018
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