Individual
MRS. JANIE DICKERT KING
Active
Individual
MRS. JANIE DICKERT KING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNP
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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