King, Jena Rae

King, Jena Rae is an individual health care provider with primary practice located at 3300 W Centre Ave , Portage MI 49024-4666. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. King, Jena Rae can be contacted via phone (269) 324-8950.

Contact Information

Primary practice address
3300 W Centre Ave Portage MI 49024-4666
Phone: (269) 324-8950
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 4704231067 Michigan

Profile Details

NPI number 1467647214
LBN Legal business name King, Jena Rae
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 13th, 2007
Last updated Oct 13th, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1467647214 NPPES
Michigan Other 500C810570 BCBSM

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