Individual
JENNIFER KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
1219 SW 4TH AVE, UNIT 1, ONTARIO, OR 97914-4566
(541) 889-2668
Mailing address
215 E HAWAII AVE, NAMPA, ID 83686-6011
(208) 463-3244
(208) 463-3338
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
AP61055386
WA
363LF0000X
Family Nurse Practitioner
Primary
201407668NP-PP
OR
363LF0000X
Family Nurse Practitioner
N-1512A
ID
Other
Enumeration date
11/03/2014
Last updated
10/08/2021
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