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General NPI Number Information
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NPI Number | 1104779610
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Entity Type | Individual
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Provider Name | JONATHAN KING PMHNP-BC
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Gender | Male
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Dates
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Enumeration Date | 02/16/2026
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Last Update Date | 02/16/2026
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Provider Practice Location Address
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Address Line | 1000 W 2ND ST
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City | LAWRENCE
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State | KS
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Zip | 66044-1426
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Country | US
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Telephone | 785-843-9192
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Fax | 785-843-2219
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Provider Business Mailing Address
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Address Line | 122 DELAWARE ST UNIT 1513
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City | KANSAS CITY
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State | MO
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Zip | 64105-2539
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Country | US
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Telephone | 785-843-9192
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Fax | 785-843-2219
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | TMP-163383
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License Number State | KS
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