Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0203X | Pediatric Critical Care Doctor | 168803 | CA |
NPI | 1003235441 |
---|---|
Provider Name | Jenny Kingsley |
First Address | Los Angeles, CA 90027-6062 |
Second Address | Nashville, TN 37232-0005 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/04/2014 |
Last Update Date | 26/08/2020 |