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NPI Code Detail

MEDICARE: JESSICA ERIN KING PSY.D.

MEDICARE: JESSICA ERIN KING PSY.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TH0100XHealth Service Psychologist

General Provider Information

NPI Number : 1215884481
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA ERIN KING PSY.D.
Provider Business Mailing Address
First Line : 3003 S ROAN ST APT 26
Second Line :
City : JOHNSON CITY
State : TN
Zip : 37601-7624
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 245 MIDWAY MEDICAL PARK
Second Line :
City : BRISTOL
State : TN
Zip : 37620-1653
Country : US
Telephone Number : 423-652-0260
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/16/2026
Last Update Date : 03/16/2026

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