Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | AGN06200314 | MA |
NPI | 1013535350 |
---|---|
Provider Name | Emily Anna Knoll |
First Address | Brookline, MA 02446-2645 |
Second Address | Brookline, MA 02446-2630 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/07/2020 |
Last Update Date | 13/07/2020 |