Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | 22287 | TN |
NPI | 1033655964 |
---|---|
Provider Name | Valerie Knight |
First Address | Clarksville, TN 37043-3799 |
Second Address | Clarksville, TN 37040-5007 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/01/2017 |
Last Update Date | 04/01/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
Q027100 | (05) | TN |