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1669779021
DUSTIN LARUE KING
JACKSON, MS
NPI
1669779021
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363LA2100X Nurse Practitioner Acute Care
(Licence: MS R875042)
Enumeration Date
2011-02-22
Last Update Date
2012-06-15
Business Address
DUSTIN LARUE KING CPNP-AC
2500 N STATE ST
JACKSON, MS 39216-4500
Phone number: 601-815-8151
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Mailing Address
DUSTIN LARUE KING CPNP-AC
2500 N STATE ST
JACKSON, MS 39216-4500
Phone number: 601-815-8151
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