Provider Demographics
NPI:1770234791
Name:KING, JESSICA ELAINE (APRN, NP-C)
Entity type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:ELAINE
Last Name:KING
Suffix:
Gender:F
Credentials:APRN, NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1221 BARRISTER CIR
Mailing Address - Street 2:
Mailing Address - City:MURPHY
Mailing Address - State:TX
Mailing Address - Zip Code:75094-4106
Mailing Address - Country:US
Mailing Address - Phone:972-743-1235
Mailing Address - Fax:
Practice Address - Street 1:406 W MAIN ST
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75013-2714
Practice Address - Country:US
Practice Address - Phone:214-495-9911
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-11
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1057356363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily