Doctor Name: | MISS JACQUELINE YVONNE KING |
NPI Number: | 1003160276 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 86654164 |
Business Practice Address: | 7212 Isherwood Rd Memphis, TN - 381252119 |
Business Phone Number: | 9016448682 |
Business Fax Number: | |
Mailing Address: | 7212 Isherwood Rd, MEMPHIS |
State: | TN |
Postal Code: | 381252119 |
Phone Number: | 9016448682 |
Fax Number: | |
NPI Enumeration Date: | 11/09/2012 |
NPI Last Update Date: | 05/16/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 172A00000X |
License Number: | 86654164 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | TN |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Driver |
Taxonomy Specialization: | |
Taxonomy Definition: | A person employed to operate a motor vehicle as a carrier of persons or property. |