Individual
JILLIAN MOORE KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
19550 E 39TH ST S, SUITE 210, INDEPENDENCE, MO 64057-2303
(816) 478-9071
Mailing address
19550 E 39TH ST S, SUITE 210, INDEPENDENCE, MO 64057-2303
(816) 478-9071
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN162789
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
131756716A
—
GA
Enumeration date
07/03/2008
Last updated
03/12/2013
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