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General NPI Number Information
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NPI Number | 1588108187
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Entity Type | Individual
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Provider Name | JENNA N. KING ARNP
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Gender | Female
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Dates
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Enumeration Date | 12/15/2016
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Last Update Date | 05/30/2023
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Provider Practice Location Address
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Address Line | 1143B N MAIN ST
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City | MUSKOGEE
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State | OK
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Zip | 74401-4441
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Country | US
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Telephone | 189-537-1973
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Fax | 918-537-1027
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Provider Business Mailing Address
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Address Line | 1143B N MAIN ST
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City | MUSKOGEE
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State | OK
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Zip | 74401-4441
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Country | US
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Telephone | 189-537-1973
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Fax | 918-537-1027
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 53-77499-052
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 210367
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License Number State | OK
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