Healthcare Provider Details

I. General information

NPI: 1245194505
Provider Name (Legal Business Name): KING HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2025
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2417 N FRONT ST
HARRISBURG PA
17110-1110
US

IV. Provider business mailing address

702 E SIMPSON ST UNIT 37
MECHANICSBURG PA
17055-1601
US

V. Phone/Fax

Practice location:
  • Phone: 717-918-9900
  • Fax: 717-918-9998
Mailing address:
  • Phone: 717-918-9900
  • Fax: 717-918-9998

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER ANN KING-WILSON
Title or Position: CEO
Credential: CRNP, CRNA
Phone: 717-918-9900