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General NPI Number Information
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NPI Number | 1497033252
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Entity Type | Individual
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Provider Name | AMANDA JEAN KING PA-C
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Gender | Female
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Dates
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Enumeration Date | 07/28/2011
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Last Update Date | 04/28/2023
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Provider Practice Location Address
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Address Line | 4755 OGLETOWN STANTON RD STE 1E50
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City | NEWARK
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State | DE
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Zip | 19718-5015
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Country | US
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Telephone | 302-733-1980
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Fax | 302-733-1986
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Provider Business Mailing Address
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Address Line | 335 RADCLIFFE ST
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City | BRISTOL
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State | PA
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Zip | 19007-5015
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Country | US
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Telephone | 215-589-8718
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Fax | 888-370-3385
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | C5-0011895
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License Number State | DE
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | MA054873
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | MA054873
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License Number State | PA
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Taxonomy #4
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | C5-0011895
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License Number State | DE
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