Provider Demographics
NPI:1124823083
Name:KING, CIARA JEWEL-ANN
Entity type:Individual
Prefix:MRS
First Name:CIARA
Middle Name:JEWEL-ANN
Last Name:KING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12265 FREMONT LN
Mailing Address - Street 2:
Mailing Address - City:ZIMMERMAN
Mailing Address - State:MN
Mailing Address - Zip Code:55398-9318
Mailing Address - Country:US
Mailing Address - Phone:763-600-3255
Mailing Address - Fax:
Practice Address - Street 1:12265 FREMONT LN
Practice Address - Street 2:
Practice Address - City:ZIMMERMAN
Practice Address - State:MN
Practice Address - Zip Code:55398-9318
Practice Address - Country:US
Practice Address - Phone:763-600-3255
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-14
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula