MEDICARE: MR. KURT MICHAEL KNOLL PA-C

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
1	363A00000X	Physician Assistant	1073	TN

General Provider Information

NPI Number	:	1518951656
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. KURT MICHAEL KNOLL PA-C

Provider Business Mailing Address
First Line	:	2910 S CHURCH ST STE B
Second Line	:
City	:	MURFREESBORO
State	:	TN
Zip	:	37127-7149
Country	:	US
Telephone Number	:	615-895-3600
Fax Number	:	615-895-0024

Provider Business Practice Location Address
First Line	:	2910 SOUTH CHURCH STREET, SUITE B
Second Line	:
City	:	MURFREESBORO
State	:	TN
Zip	:	37127-7149
Country	:	US
Telephone Number	:	615-895-3600
Fax Number	:	615-895-0024

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/05/2005
Last Update Date	:	12/04/2025

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