Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PP0204X | Pediatric Emergency Physician | PA2273 | NV |
NPI | 1225662125 |
---|---|
Provider Name | Erin Paige Knudson |
First Address | Peoria, AZ 85382-8122 |
Second Address | Las Vegas, NV 89109-2317 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/02/2020 |
Last Update Date | 28/02/2020 |