Provider Demographics
NPI:1790015808
Name:KING, JANE F (RN)
Entity Type:Individual
Prefix:MS
First Name:JANE
Middle Name:F
Last Name:KING
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:347 1ST AVE
Mailing Address - Street 2:#5
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-5612
Mailing Address - Country:US
Mailing Address - Phone:212-810-9943
Mailing Address - Fax:
Practice Address - Street 1:347 1ST AVE
Practice Address - Street 2:#5
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-5612
Practice Address - Country:US
Practice Address - Phone:212-810-9943
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-12
Last Update Date:2010-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY619845163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse