MEDICARE: JANA DEE KING FNP-C

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
1	207Q00000X	Family Medicine Physician	F08250580	AZ

General Provider Information

NPI Number	:	1306723507
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANA DEE KING FNP-C

Provider Business Mailing Address
First Line	:	8528 W CAVALIER DR
Second Line	:
City	:	GLENDALE
State	:	AZ
Zip	:	85305-2504
Country	:	US
Telephone Number	:	623-329-5199
Fax Number	:

Provider Business Practice Location Address
First Line	:	21755 N 77TH AVE STE 16
Second Line	:
City	:	PEORIA
State	:	AZ
Zip	:	85382-2111
Country	:	US
Telephone Number	:	623-329-5199
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/19/2025
Last Update Date	:	08/19/2025

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Directions to “ JANA DEE KING FNP-C” Practice Location

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