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General NPI Number Information
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NPI Number | 1629867296
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Entity Type | Individual
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Provider Name | JANE KING CNP
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Gender | Female
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Dates
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Enumeration Date | 05/01/2025
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Last Update Date | 10/02/2025
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Provider Practice Location Address
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Address Line | 3533 SOUTHERN BLVD STE 2100
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City | KETTERING
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State | OH
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Zip | 45429-1267
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Country | US
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Telephone | 937-395-8556
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Fax |
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Provider Business Mailing Address
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Address Line | 235 WOODSTREAM DR
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City | SPRINGBORO
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State | OH
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Zip | 45066-8216
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Country | US
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Telephone | 304-552-4313
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Fax |
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 0039065
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License Number State | OH
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