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Individual

MRS. JANIE DICKERT KING

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CRNP

Contact information

Practice address
324 MACON ST, SUITE 2, EUFAULA, AL 36027-1810
(334) 687-2494
(334) 687-5584
Mailing address
324 MACON ST, SUITE 2, EUFAULA, AL 36027-1810
(334) 687-2494
(334) 687-5584

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
1-044439
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
515-21355
BLUE CROSS BLUE SHIELD AL
AL
Enumeration date
09/25/2006
Last updated
02/09/2010
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