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Individual

JENNIFER P KING

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
100 S DUNCAN ST, JAMESTOWN, TN 38556-3009
(931) 879-5864
(931) 879-3903
Mailing address
229 INTERSTATE DR, SUITE 103, CROSSVILLE, TN 38555-2709
(931) 210-5577
(931) 210-5575

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
1695
TN
363AM0700X
Medical Physician Assistant
Primary
001695
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1695
TN STATE LICENSE
TN
Enumeration date
02/05/2009
Last updated
12/10/2018
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