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NPI Code Detail

MEDICARE: KATIE KNIGHT WATERS

MEDICARE: KATIE KNIGHT WATERS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician AssistantPA9112252FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1184273336
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATIE KNIGHT WATERS
Provider Business Mailing Address
First Line : 7751 BELFORT PKWY STE 350
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32256-6951
Country : US
Telephone Number : 904-363-7453
Fax Number :
Provider Business Practice Location Address
First Line : 7015 A C SKINNER PKWY STE 1
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32256-6932
Country : US
Telephone Number : 904-739-7779
Fax Number : 904-739-7771
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/10/2019
Last Update Date : 02/16/2026

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Directions to “ KATIE KNIGHT WATERS ” Practice Location

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