Provider Demographics
NPI:1770116998
Name:KING, JANICE (FNP-C)
Entity type:Individual
Prefix:
First Name:JANICE
Middle Name:
Last Name:KING
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:147 NC HIGHWAY 24 STE 102
Mailing Address - Street 2:
Mailing Address - City:MOREHEAD CITY
Mailing Address - State:NC
Mailing Address - Zip Code:28557-8982
Mailing Address - Country:US
Mailing Address - Phone:252-726-4000
Mailing Address - Fax:252-726-2530
Practice Address - Street 1:147 NC HIGHWAY 24 STE 102
Practice Address - Street 2:
Practice Address - City:MOREHEAD CITY
Practice Address - State:NC
Practice Address - Zip Code:28557-8982
Practice Address - Country:US
Practice Address - Phone:252-726-4000
Practice Address - Fax:252-726-2530
Is Sole Proprietor?:No
Enumeration Date:2020-02-17
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5012933363LA2200X
NCF02200203207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health