MEDICARE: MRS. JANECIA LYNN KING NP

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	APRN.CNP.09517	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1558554014
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JANECIA LYNN KING NP

Provider Business Mailing Address
First Line	:	2868 COMPTON RD STE 100
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45251-2634
Country	:	US
Telephone Number	:	513-712-8182
Fax Number	:	513-880-0606

Provider Business Practice Location Address
First Line	:	2868 COMPTON RD STE 100
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45251-2634
Country	:	US
Telephone Number	:	513-712-8182
Fax Number	:	513-880-0606

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

Provider Enumeration Date	:	08/19/2007
Last Update Date	:	05/06/2024

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